1. (1) To be eligible for reimbursement for the covered costs of the forensic rape examination, the medical provider must, within 90 days of performing the examination:

   1. (a) submit the FREPP claim form;
   2. (b) provide a copy of the patient information form;
   3. (c) provide an itemized statement of charges listing current procedural terminology (CPT) codes on a standard health care financing administration (HCFA) form; and
   4. (d) provide copies of all pertinent treatment records.
2. (2) All billing paperwork should be mailed to the Office of Victim Services, ATTN: FREPP, P.O. Box 201410, 1712 9th Ave., Helena, MT 59620-1410.

Authorizing statute(s): 46-15-411, MCA

Implementing statute(s): 46-15-411, MCA

History: NEW, 2005 MAR p. 2063, Eff. 10/28/05.