Wyoming Administrative Code
Agency 006 - Administration and Information, Dept. of
Sub-Agency 0001 - Wyoming Frontier Health Information Exchange (WYFI) Program
Chapter 3 - GRIEVANCE PROCEDURE
Section 3-6 - Initiation of Proceedings

Universal Citation: WY Code of Rules 3-6

Current through September 21, 2024

A proceeding before the Board shall be initiated by the filing of a statement by the claimant. Said statement shall be filed within one (1) year of the date upon which occurred the event forming the basis of the grievance. Said statement shall contain the following:

(a) The claimant's name, address, telephone number, social security number, and place of employment.

(b) A brief description of the matter to be brought before the Board.

(c) If the matter involves the denial of coverage or of a claim, the statement shall include the reasons for denial, as understood by the claimant.

(d) Copies of any relevant documents, including but not limited to bills, statements, and the carrier's explanation of benefits.

(e) Information regarding any contacts the claimant has had with the opposing party regarding the claim, including attempts to settle the claim and dispute.

(f) A statement verifying that a copy of the statement of initiation of the grievance has been sent to the carrier or other opposing party, and stating the date upon which said copy was sent.

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