How does a healthcare provider apply for Direct Reimbursement?

How does a healthcare provider apply for Direct Reimbursement?

Medical Provider Forensic Rape Examination Direct Reimbursement Claim Forms are available from the OVS website and are included in the Sexual Offense Evidence Collection Kit provided free of charge to hospitals and healthcare providers throughout the State.

No later than one year from the date of the forensic examination, the healthcare provider in whose facility the exam took place must submit a completed Medical Provider Forensic Rape Examination Direct Reimbursement Claim Form* AND an itemized bill indicating the relevant current procedural terminology (CPT) codes and the costs associated with each service provided, to the OVS at the address below.

New York State Office of Victim Services
Attn: FRE Processing 
AE Smith Building
80 S. Swan Street, 2nd FL 
Albany, NY 12210

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