When can I submit an interim payment request?

An interim payment may be requested on an application when the following conditions are met:

• The application is approved.
• Payment Setup is complete.
• The maximum number of twelve (12) interim payment requests for a plan year has not been reached.
• New interim costs were submitted for at least one Benefit Option since the last payment request, and the Payment Requester completed the review for the new interim costs.
• At least 16 business days have passed since the last payment approval, or 31 business days have passed since the last payment request; whichever is later.
• To request another interim payment, the Next Payment Request status displays "Payment Can Now Be Requested." If a payment request is in progress, the Plan Sponsor cannot request payment.

NOTE: All RDS applications have a maximum payment frequency of monthly interim payments, consistent with the general payment rules regarding timing set forth in 42 C.F.R. 423.888(b)(1). Although 12 interim payment requests are permitted, a Plan Sponsor may choose to submit fewer than 12 interim payment requests, or forego interim payments and instead choose to submit one final payment request during Reconciliation as described in 42 C.F.R. 423.888(b)(2)(ii).