WebEffective September, 1, 2024, gas mileage reimbursement will be limited to the nearest medically appropriate and qualified provider not to exceed 125 miles from the member's home in-state or within 30 miles of the West Virginia border. Web0hglfdlg )hh )ru 6huylfh 1rw 7r %h 8vhg e\ 0dqdjhg &duh 0hpehuv 5htxhvw iru 5hlpexuvhphqw ri 0hglfdo 7udqvsruwdwlrq e\ 3ulydwh &du %xv ru 7udlq
TRAVEL AND EMPLOYEE EXPENSE REIMBURSEMENT
WebOct 1, 2024 · Effective July 1, 2007 Employees who are disabled and use their own personal adapted vehicle on State business, shall receive the current mileage reimbursement … WebMay 17, 2024 · DHB-2055 Reimbursement for Medical Transportation. Medicaid Form Number. DHB-2055. Agency/Division. Health Benefits/NC Medicaid (DHB) Form Effective Date. 2024-05-17. Form File. philly management company
NONRECURRING EXPENSES ELIGIBILITY AND …
WebExpense Reimbursement form for authorized meals and lodging. Expense Instruction Letter. ... Mileage reimbursement will be paid at a specified rate per mile for each mile that the member is driven in the vehicle. Mass Transit - Where available and suitable for the physical condition of the member. This will be the mode of transportation for ... WebWEST VIRGINIA GAS MILEAGE REIMBURSEMENT TRIP LOG Mail or Fax to: LogistiCare Claims Department 798 Park Avenue NW Norton, VA 24273 Fax #: 866-528-0462 Gas Mileage Reimbursement Billing Inquiries: 844-889-1942 DRIVER NAME: DRIVER PHONE #: DRIVER MAILING ADDRESS: CITY/STATE/ZIP: WebDownload a form, learn more about a letter you got ... Get Medicare forms for different situations, like filing a claim or appealing a coverage decision. Find Forms Publications Read, print, or order free Medicare publications in a variety of formats. Get Publications Mailings Find out what to do with Medicare information you get in the mail. ... tsb download pdf statement