e. Contract approval - Laserfiche WebLink

Bills for these medical services must be sent on Form HCFA-1500 (Health Insurance Claim Form) to the DOCR Adult Services Division Medical Department, PO Box 5521, Bismarck, NO 58506-5521 . The DOCR will pay for emergency medical services without prior approval; however, the Contractor shall notify the DOCR Adult Services Division Medical Director as soon as possible after the emergency, and must use medical providers who accept Medicaid reimbursement. The Contractor shall obtain the DOCR's authorization prior to providing a DOCR offender non- emergency dental, optical, or any other health or medical services in excess of $150.00. The DOCR will not pay for any non-emergency dental, optical, or any other health or medical services unless the Contractor has obtained the DOCR's authorization prior to providing the services. Prior to the DOCR's physical placement of an offender with the Contractor, the Contractor may accept or deny placement of DOCR offenders. Once the Contractor has accepted an offender, the Contractor shall provide the offender with necessary medical care in accordance with this Contract. The Director of the DOCR retains the authority to return offenders from the Contract facility to the DOCR or approve payment to provide the offender with necessary medical care locally. ARTICLE IV . RECEIVING AND DISCHARGE The Contractor agrees to accept offenders sentenced to the legal and physical custody of the DOCR after presentation and opportunity for review of a referral package from the DOCR. In the event the offender has just been sentenced to the DOCR, the Contractor shall provide an intake record and documentation required by the DOCR. The Contractor also agrees to accept offenders who have been taken into custody for violation of parole. The Contractor may not release, discharge, or transfer a DOCR offender from its physical custody, including release from custody, transfer to other correctional facility, law enforcement agency, or to another governmental agency or institution, without first notifying and receiving the approval of the DOCR Adult Services Division. After obtaining authorization from the DOCR for release from custody, transfer to other correctional facility, or to another governmental agency or institution, the Contractor shall complete any discharge paperwork, including victim notifications. ARTICLE V . RETURN OF OFFENDERS TO THE DOeR ADULT SERVICES DIVISION In the event that an inmate housed in the Contractor's facility causes a major disturbance, becomes unmanageable, or becomes uneconomical for the Contractor, the Contractor may request that the offender be transported to the DOeR. The Contractor shall first notify the Warden or the Captain on duty and request that the offender be transferred to the DOCR. Whenever possible, the Contractor shall provide 24-hour notice to the DOCR with a written report to follow. Page 2