Utah Admin. Code R414-32-4 - Discrepancies Between Services and Charges

(1) If there is no documentary evidence to support charges for ancillary services, the Department shall notify the hospital in writing of the discrepancy.
(2) If the hospital, within 30 days of notification, compiles and submits documentary evidence to support the charges, then the Department shall consider the evidence sufficient to provide payment.
(3) If the hospital does not place the evidence in the medical record and submit that evidence to Medicaid within 30 days after notification, the Department will not reimburse the hospital nor accept subsequent documentation for the unsupported charges.

Notes

Utah Admin. Code R414-32-4
Adopted by Utah State Bulletin Number 2023-15, effective 7/26/2023

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