R398-3-4. Process to Review and Pay for Services Provided to a Child

  (1) Applications

  a. Participant application

  i. Must be completed by parent or guardian.

  ii. If a child is under three years of age, the child shall participate in a Part C Early Intervention program.

  iii. Application must be submitted to managing audiologist with:

  1. Proof of denial for Medicaid or evidence that family is ineligible for Medicaid.

  2. Evidence of non-coverage by current insurance provider.

  i. Family/guardian shall provide coverage for all out-of-warranty repairs.

  ii. If L and D is claimed during the warranty period, the family shall provide supplemental hearing aid insurance including L and D.

  iii. Child will receive hearing aids directly from managing audiologist.

  a. Audiologist qualifications and application

  i. Hearing aid must be fit by a licensed audiologist.

  ii. A separate application must be submitted for each child.

  (2) Review of applications

  a. All applications will be reviewed for completeness and eligibility by the Advisory Committee chair or UDOH designee.

  b. Eligibility shall be communicated to the managing audiologist.

  (3) Payment process

  a. Within 30 days of hearing aid fitting, the managing audiologist will submit the Payment Request Cover Sheet with all supporting documentation.

  b. UDOH will review documentation to assure that managing audiologist has submitted all items listed in payment request.

  c. Payments will go directly to the managing audiologist or their designee.