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 3-9 - Verification of Client Data

(a) The Department issues Medicaid identification numbers to clients. The provider is responsible for verifying the validity of each client's Medicaid identification.

(b) The provider will not be paid for any claims submitted for treatment of an individual who does not have a valid Medicaid identification number. If a provider receives payment from an individual that is later determined to be eligible for Medicaid, the provider shall refund any such payment to the individual before seeking Medicaid reimbursement.

(c) If a provider furnishes services to an individual who purposely fails to notify the provider that he is a Medicaid client, the provider may submit a claim to Medicaid or seek reimbursement or payment from the client. A provider that elects to seek Medicaid reimbursement shall accept such payment as payment in full.

(d) A provider that furnishes services to an individual who becomes a Medicaid client after the date services were provided may submit a claim to the Department seeking Medicaid reimbursement for services furnished during the period the individual was eligible for Medicaid.