Idaho Payment Resources



Summary of payment program


Billing

Effective July 1, 2018, under Idaho Codes § 19-5303 and 72-1019(2), an adult victim’s (18 years of age and older) private insurance should not be billed for a sexual assault forensic and medical examination. This statutory change applies to dates of service on or after July 1, 2018.

If the adult victim participates in a federally financed benefit program (i.e., Medicaid, Medicare, VA Benefits), then reimbursement for the sexual assault forensic and medical examinations should first be processed through that program before Idaho’s Crime Victims Compensation Program (CVCP). The one exception to this is for adult victims with Indian Health Services (IHS) benefits. In this instance, CVCP will be billed for the sexual assault forensic and medical examination before seeking reimbursement from IHS.

Sexual assault forensic and medical examinations costs for minor victims (age 17 and under), should first be routed through all benefit programs (private health insurance, Medicaid, Medicare, VA). Then, any remaining balance will be reviewed by CVCP to determine if the Program can provide reimbursement. The one exception to this is for minor victims with Indian Health Services (IHS) benefits. In this instance, providers will bill CVCP for the sexual assault forensic and medical examination before seeking reimbursement from IHS.

Sexual assault forensic and medical examination costs covered by the program include but are not limited to examiner fees, facility fees, laboratory fees, antibiotics for Sexually Transmitted Infections, and other medications.

The Program will request the following from medical providers who assisted the victim:

  • UB04, CMS1500, or itemized billing statements with CPT and REV codes.
  • Sexual Assault Nurse Examination Records
  • Explanation of Benefits if the victim has federal/state insurance.

Payment


Idaho’s Crime Victims Compensation Program (CVCP) is committed to supporting and ensuring eligible victims are provided appropriate financial assistance to aid in recovery from the traumatic effects of crime.

When a victim of sexual assault presents at the hospital or clinic, a determination should be made if the crime has been reported to law enforcement or if the victim wants it reported.

  • Sexual assault has been or will be reported to law enforcement: CVCP encourages the victim to complete and sign the Program’s Application for Compensation.
    Completing this application allows the Program to initially pay costs associated with the sexual assault forensic and medical examinations (see above details under Billing). Additionally, if the victim is found eligible, they may access additional benefits available through the Program, including but not limited to medical (including imaging), mental health, and wage loss benefits.

    Eligibility requirements include:
    • Signed Application.
    • Crime must have occurred in Idaho.
    • Reported to law enforcement within 72 hours of occurrence or show good cause for failing to do so.
    • Application filed within one year of the incident, or show good cause for failing to do so.
    • Victim cooperation with law enforcement and prosecution.
    • Preponderance of evidence.

    • Good cause will be determined at the Programs discretion on a case-by-case basis. For more information on eligibility requirements, visit our webpage.

  • Victim does not or does not wish to disclose Sexual Assault to law enforcement: CVCP encourages the victim to complete the Sexual Assault Forensic Examination Reimbursement Application.
    This application should be used by victims who are primarily seeking reimbursement for only the cost of sexual assault forensic and medical examination. Eligibility requirements include:
    • Signed application.
    • Crime must have occurred in Idaho.
    • Application filed within one year of the incident or show good cause for failing to do so.


    Good cause will be determined at the Programs discretion on a case-by-case basis.

    It is important to know that this application may not cover all costs associated with the victim’s medical visit.

    If the victim changes their mind and later reports to law enforcement or if they are seeking additional benefits from CVCP after the fact, they should contact the Program directly, by calling 208-334-6080 or via email at cvcp.admin@iic.idaho.gov

  • Medical Providers should review Idaho Codes §72-1026 and Administrative Rules Under the Crime Victims Compensation Act. Payments made by the CVCP are based on the medical fee schedule authorized under administrative rules. Payments will be based on the medical fee schedule in place at the time of service. Additionally, a medical provider who accepts the full allowable payment from the commission under this chapter for medical services provided to a victim or claimant shall be deemed to have agreed to accept those payments as payment in full for those medical services.

  • Out-of-Pocket Reimbursement to Victims: If a victim is found eligible and paid for medical bills or other crime-related expenses, the program may reimburse them.

  • Medical bills received by CVCP, but no application received: If the Program received a medical bill for a sexual assault forensic and medical examination but does not receive a signed application from the victim, CVCP will hold the medical bill(s) for 30 days. The program will contact the victim to request completion of the application. The medical bills will be destroyed if no signed application is received within 60 days.

  • CVCP cannot pay Property Damages. However, the Program can pay for certain medically necessary items, such as eyeglasses, contacts, medical and dental prostheses, and other medical devices or aids.


Completed and signed applications can be sent via:
  • Email to: cvcp.admin@iic.idaho.gov
  • Fax: 208-332-7559
  • Mail to:
  • Idaho CRIME VICTIMS COMPENSATION PROGRAM
    • P.O. BOX 83720
      BOISE, ID 83720-0041

CVCP staff are available to discuss application questions with victims who call 208-334-6080.