Rule 13 Request for Medical Expense and Treatment Verification
Rule Text
(a) IN GENERAL. If a claimant seeks compensation for a victim’s or secondary victim’s medical expenses for injuries related to a crime, the Program must request:
(1) a copy of all medical bills related to the claim from any individual or entity providing medical services to the victim or secondary victim; and
(2) a certification from the medical provider, under the penalty of perjury, indicating:
(A) the dates of medical services;
(B) the final amount due from the victim or secondary victim; and
(C) that the services were directly related to the crime.
(b) ADDITIONAL INFORMATION. If the Program determines, in its sole discretion, that it needs additional information in deciding whether to approve a claim related to medical expenses, the Program may request the victim’s or secondary victim’s medical records. The victim or secondary victim must provide any necessary authorization for release of the medical records.
(c) FORM OF REQUEST. The Program’s request for the medical certification and the medical bills or records must include the victim’s or secondary victim’s authorization provided in accordance with Rule 9(j) or 13(b).