Or. Admin. Code § 333-004-3120 - Timely Submission of RH Access Fund Claims

(1) RH Access Fund claims are processed once a month. To be included in a given month's processing, an agency must submit a claim to the RH Program via the RH Program's contracted data and claims processing vendor and the RH Program must receive the claim before the monthly processing deadline.

(2) The RH Program shall pay claims within 12 months of the date of service. Claims submitted more than 12 months after the date of service shall be rejected.

(3) Errors causing rejection of any claim must be resolved by the agency within 12 months of the date of service. Claims older than 12 months submitted by the agency to the RH Program shall not be paid, except when the RH Program has made an error that caused the agency not to be able to bill within 12 months of the date of service. The error must be confirmed by the RH Program before the claim shall be paid.

(4) Data not related to payment of the claim may be corrected by the agency at any time after the date of service.

(5) Agencies may void claims at any time after the date of service.

Notes

Or. Admin. Code § 333-004-3120

PH 84-2020, adopt filed 12/18/2020, effective 1/1/2021; PH 189-2022, minor correction filed 09/07/2022, effective 9/7/2022; PH 89-2024, minor correction filed 11/26/2024, effective 11/26/2024

Statutory/Other Authority: ORS 413.042, ORS 414.432, ORS 431.147, ORS 431.149, ORS 435.205 & ORS 435.230

Statutes/Other Implemented: ORS 414.432, ORS 431.147, ORS 413.032, ORS 435.205 & ORS 435.230