28 Tex. Admin. Code § 21.2816 - Date of Receipt

(a) A written communication, including a claim, referenced under this subchapter is subject to and must comply with this section unless otherwise stated in this subchapter.

(b) An entity subject to these rules may deliver written communications as follows:

(1) submit the communication by United States mail, first class; by United States mail, return receipt requested; or by overnight delivery;

(2) submit the communication electronically and maintain proof of the electronically submitted communication;

(3) if the entity accepts facsimile transmissions for the type of communication being sent, fax the communication and maintain proof of facsimile transmission; or

(4) hand deliver the communication and maintain a copy of the signed receipt acknowledging the hand delivery.

(c) If a communication is submitted by United States mail, first class, the communication is presumed to have been received on the fifth day after the date the communication is submitted, or, if the communication is submitted using overnight delivery service or United States mail return receipt requested, on the date the delivery receipt is signed.

(d) If a communication other than a claim is submitted electronically, the communication is presumed received on the date of submission. Communications electronically submitted after the receiving entity's normal business hours are presumed received the following business day.

(e) If a claim is submitted electronically, the claim is presumed received on the date of the electronic verification of receipt by the MCC or the MCC's clearinghouse. If the MCC's clearinghouse does not provide a confirmation of receipt of the claim or a rejection of the claim within 24 hours of submission by the physician, or the provider, or the physician's or provider's clearinghouse, the physician's or provider's clearinghouse must provide the confirmation. The physician's or provider's clearinghouse must be able to verify that the claim contained the correct payor identification of the entity to receive the claim.

(f) If a communication is faxed, the communication is presumed to have been received on the date of the transmission acknowledgement. Communications faxed after the receiving entity's normal business hours are presumed received the following business day.

(g) If a communication is hand delivered, the communication is presumed to have been delivered on the date the delivery receipt is signed.

(h) Any entity submitting a communication under subsection (b)(1) - (4) of this section may choose to maintain a mail log to provide proof of submission and establish date of receipt. The entity must fax or electronically transmit a copy of the mail log, if used, to the receiving entity at the time of the submission of a communication and include another copy with the relevant communication. The log must identify each separate claim, request for information, or response included in a batch communication. The mail log must include the following information: name of claimant; address of claimant; telephone number of claimant; claimant's federal tax identification number; name of addressee; name of MCC; designated address; date of mailing or hand delivery; subscriber name; subscriber ID number; patient name; date(s) of service or occurrence; delivery method; and claim number, if applicable.

Notes

28 Tex. Admin. Code § 21.2816

The provisions of this §21.2816 adopted to be effective October 2, 2001, 26 TexReg 7542; amended to be effective October 5, 2003, 28 TexReg 8647; amended to be effective February 16, 2014, 39 TexReg 747