Financial Agreement and Attestations - Medicaid Pediatric Healthcare Recovery Program - Rhode Island

Financial Agreement and Attestations - Medicaid Pediatric Healthcare Recovery Program - Rhode Island

Financial Agreement and Attestations - Medicaid Pediatric Healthcare Recovery Program is a legal document that was released by the Rhode Island Executive Office of Health and Human Services - a government authority operating within Rhode Island.

FAQ

Q: What is the Medicaid Pediatric HealthcareRecovery Program in Rhode Island?
A: The Medicaid Pediatric Healthcare Recovery Program in Rhode Island is a financial agreement to recover funds from responsible third parties.

Q: Who is eligible for the program?
A: Medicaid enrollees in Rhode Island are eligible for the program.

Q: What does it mean to be a responsible third party?
A: A responsible third party is an individual or entity that may be liable for payment for medical services provided to a Medicaid enrollee.

Q: What is the purpose of the financial agreement?
A: The purpose of the financial agreement is to ensure repayment of Medicaid funds from responsible third parties when applicable.

Q: How does the recovery process work?
A: The recovery process involves identifying responsible third parties, notifying them of their potential liability, and pursuing collection efforts to recover funds.

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Form Details:

  • Released on August 30, 2022;
  • The latest edition currently provided by the Rhode Island Executive Office of Health and Human Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Rhode Island Executive Office of Health and Human Services.

Download Financial Agreement and Attestations - Medicaid Pediatric Healthcare Recovery Program - Rhode Island

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