Idaho State Statutes - Idaho Attorney Directory

Applications and requests for necessary medical services shall be filed with
the clerk according to the following time limits. Filing is complete upon
receipt by the clerk.
(1) An application for nonemergency necessary medical services shall be
filed ten (10) days prior to receiving services from the provider.
(2) An application for emergency necessary medical services shall be made
any time within thirty-one (31) days beginning with the first day of the
provision of necessary medical services from the provider or in the case of
hospitalization, thirty-one (31) days beginning with the date of admission.
(3) Requests for additional treatment related to an original diagnosis in
accordance with a preapproved treatment plan shall be filed ten (10) days
prior to receiving services.
(4) A delayed application for necessary medical services may be filed up
to one hundred eighty (180) days beginning with the first day of the provision
of necessary medical services provided that:
(a) Written documentation is included with the application or no later
than forty-five (45) days after an application has been filed showing that
a bona fide application or claim has been filed for social security
disability insurance, supplemental security income, third party insurance,
medicaid, medicare, crime victim's compensation, and/or worker's
compensation. A bona fide application means that:
(i) The application was timely filed within the appropriate
agency's application or claim time period; and
(ii) Given the circumstances of the patient and/or obligated
persons, the patient and/or obligated persons, and given the
information available at the time the application or claim for other
resources is filed, would reasonably be expected to meet the
eligibility criteria for such resources; and
(iii) The application was filed with the appropriate agency in such a
time and manner that, if approved, it would provide for payment
coverage of the bills included in the county application; and
(iv) In the discretion of the board, bills on a delayed application
which would not have been covered by a successful application or
timely claim to the other resource(s) may be denied by the board as
untimely; and
(v) In the event an application is filed for supplemental security
income, an Idaho medicaid application must also have been filed
within the department of health and welfare's application or claim
time period to provide payment coverage of eligible bills included in
the county application.
(b) Failure by the patient and/or obligated persons to complete the
application process described in this section, up to and including any
reasonable appeal of any denial of benefits, with the applicable program
noted in paragraph (a) of this subsection, shall result in denial of the
county assistance application.
(5) Any application or request which fails to meet the provisions of this
section, and/or other provisions of this chapter, shall be denied.
(6) In the event that a county determines that a different county is the
obligated county, an application may be filed in the other county within
thirty (30) days of the date of the initial county denial.

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