WAC 110-50-0950. Determining the reimbursable amount for third party liability claims

The caregiver claims manager must: (1) Review third party liability claims and determine the reimbursable costs for: (a) Damaged or destroyed items in the following order by determining if the items: (i) Can be cleaned or repaired; or (ii) Cannot be cleaned or repaired. If the item cannot be cleaned or repaired, the department will determine the comparable replacement cost using estimates based on the same attributes as the items that were damaged or destroyed; (b) Emergency medical expenses related to the occurrence for the third party, including: (i) Medical; (ii) Dental; and (iii) Vision; (c) Personal injuries as determined by department of enterprise services office of risk management or court order; and (d) Court costs related to the occurrences; (2) Provide the final decision in writing that includes: (a) The department's decision on whether the claims are eligible for reimbursement; and (b) The amount the department will pay for eligible items; (3) Pay for approved claim items within program limits and available funds; and (4) Maintain oversight of claims and payments.