New Hampshire Code of Administrative Rules
Jus - Attorney General, Department of Justice
Chapter Jus 600 - VICTIMS' COMPENSATION
Part Jus 604 - FORMS
Section Jus 604.07 - Verification of Hospital Expenses Form
Universal Citation: NH Admin Rules Jus 604.07
Current through Register No. 40, October 3, 2024
If a claimant seeks compensation for hospital expenses, the victim or victim's parent or guardian shall complete and submit a HIPAA- compliant hospital and/or medical release. Upon receipt of the HIPAA- compliant release form the unit shall request that each provider complete and submit a "Verification of Hospital Expenses Form," as revised 8/23/2019, and provide an itemized statement and medical records to injuries directly resulting from the crime.
#4864, eff 7-13-90; amd by #5430, eff 7-1-92; ss by #7117, eff 10-8-99, EXPIRED: 10-8-07
New. #9553, eff 9-25-09
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