Wisconsin Revised Reimbursement Order (Chapter 51)

State:
Wisconsin
Control #:
WI-SKU-2000
Format:
PDF
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Description

Revised Reimbursement Order (Chapter 51) Wisconsin Revised Reimbursement Order (Chapter 51) is a legal order issued by the Wisconsin Department of Health Services (DHS) that requires health care providers to reimburse a Medicaid recipient for medical expenses that were paid by the recipient. The order is used when a provider or facility fails to pay the recipient’s Medicaid claim or pays only a portion of the claim. It is also used when a Medicaid recipient has received services from a provider who is not enrolled in the Medicaid program. The order is divided into three types: Administrative Order, Statutory Order, and Court Order. Administrative Order allows the DHS to order a provider to reimburse a Medicaid recipient for medical expenses paid by the recipient, as well as any applicable interest, penalties, or damages. Statutory Order requires the provider to reimburse the recipient for medical expenses and any applicable interest or penalty, and also allows the DHS to collect a penalty of up to $500 per violation. Court Order is a court-ordered reimbursement to the Medicaid recipient and allows the court to determine the amount of reimbursement due. Wisconsin Revised Reimbursement Order (Chapter 51) is an important tool for Medicaid recipients to ensure they receive the care they need and are not taken advantage of by providers.

Wisconsin Revised Reimbursement Order (Chapter 51) is a legal order issued by the Wisconsin Department of Health Services (DHS) that requires health care providers to reimburse a Medicaid recipient for medical expenses that were paid by the recipient. The order is used when a provider or facility fails to pay the recipient’s Medicaid claim or pays only a portion of the claim. It is also used when a Medicaid recipient has received services from a provider who is not enrolled in the Medicaid program. The order is divided into three types: Administrative Order, Statutory Order, and Court Order. Administrative Order allows the DHS to order a provider to reimburse a Medicaid recipient for medical expenses paid by the recipient, as well as any applicable interest, penalties, or damages. Statutory Order requires the provider to reimburse the recipient for medical expenses and any applicable interest or penalty, and also allows the DHS to collect a penalty of up to $500 per violation. Court Order is a court-ordered reimbursement to the Medicaid recipient and allows the court to determine the amount of reimbursement due. Wisconsin Revised Reimbursement Order (Chapter 51) is an important tool for Medicaid recipients to ensure they receive the care they need and are not taken advantage of by providers.

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Wisconsin Revised Reimbursement Order (Chapter 51)