Ch. 1, § 8. Provider Eligibility, Reimbursement, and Billing

(a) A healthcare provider may automatically participate in the WCCSP if they are approved as a Wyoming Medicaid provider with a qualifying taxonomy code. (b) A participating healthcare provider may not receive reimbursement for covered services rendered to a client enrolled in the WCCSP unless the provider submits the appropriate clinical documentation for the services performed, in the form and manner prescribed by the Department. (c) The Department shall reimburse a participating healthcare provider for covered services rendered to a client enrolled in the WCCSP at the current Wyoming Medicaid allowable rates for the date of service. (d) A participating healthcare provider shall accept the Department's payment for covered services as paid in full. (e) A participating healthcare provider may not bill the client, or any member of the client's family, for services covered by the WCCSP. This prohibition includes imposing additional charges for covered services. (f) A participating healthcare provider may bill a client enrolled in WCCSP if services provided are not covered by the WCCSP, and, prior to providing services, the provider informs the client in writing that the service is non-covered and the client is responsible for those charges. (g) For persons who are underinsured, the program shall only pay for expenses not covered by insurance. 1-1