ARSD 46:30:08:05
ARSD 46:30:08:05. Application
Cite as S.D. Admin. R. 46:30:08:05
The applicant shall submit a completed and signed application on a form provided by the division and shall include the following information:
(1) Documentation from the applicant's implant surgeon that one or two cochlear implants is medically recommended;
(2) Documentation of a progressive hearing loss which led to deafness, if applicable;
(3) A written quote of the provider's usual and customary charge for services listed in § 46:30:08:03; and
(4) Proof of creditable coverage as defined in SDCL 58-18-44, if any.
The division shall reject an application that fails to provide the required information.