INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Subject: Listing client spenddown and/or EMER on UB-92 Claim Form.
Effective Date: June 1, 2002.
Document description: The purpose of this numbered memorandum is to clarify to hospitals the difference between spenddown and EMER for the medically indigent program and where each one MUST be placed on the UB-92 claim form in order for the hospital to be reimbursed properly. Sample completed UB-92 forms accompany this document.
To receive a copy of the interpretive or policy statement, contact Kevin Sullivan, Regulatory Improvement Coordinator, Department of Social and Health Services, Medical Assistance Administration, Division of Program Support, P.O. Box 45533, Olympia, WA 98504-5533, phone (360) 725-1344 or go to website http://maa.dshs.wa.gov (click on Numbered Memorandum link), TDD 1-800-848-5429, fax (360) 586-9727, e-mail mailto:email@example.com.
July 10, 2002
E. A. Myers, Manager
Rules and Publications Section