Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 3 - PROVIDER ENROLLMENT AND PARTICIPATION, PRE-AUTHORIZATION, PAYMENT AND SUBMISSION OF CLAIMS BY PROVIDERS
Section 3-12 - Payment of Claims

(a) Medicaid is the payer of last resort. A provider may not seek Medicaid payment for services furnished to a client until payment from third parties has been sought pursuant to Wyoming Medicaid Rules Chapter 35.

(b) For Medicaid enrolled providers, if the service is a covered service, a provider may not request, receive or attempt to collect any payment from the client or the client's family for the service, with the exception of section 9(c) of this Chapter. The provider shall accept the Medicaid allowable payment as payment in full for the services.

(c) A provider that provides a noncovered service to a client may seek payment from the client if the provider informed the client in writing of the client's potential liability before providing the service, and the client agreed in writing to pay for such services before they were furnished.

(d) A provider that provides a covered service to a client that is in excess of service limits may seek payment from the client if the provider informed the client in writing of the client's potential liability before providing the service, and the client agreed in writing to pay for such services before they were furnished.

(e) A provider may seek copayment from clients as permitted by Department policy as reflected in the Department's manuals and bulletins. The amount of the permitted copayment shall be automatically deducted by the Department from the Medicaid Allowable Payment. Collection of a permitted copayment is at the discretion of the provider.