Utah Admin. Code R428-15-4 - Reporting Requirements
(1) Each carrier
shall submit health care claims data described in the applicable Data
Submission Guide for Claims Data, incorporated by reference within Subsection
R428-1-4(4),
for each covered person whose primary residence is Utah, regardless of where
the services are provided.
(2)
(a) Each carrier shall submit data for each
field contained in the Data Submission Guide for Claims Data if the data is
available to the carrier.
(b) Each
carrier shall notify the department or its designee of any data element that is
required to be reported under this rule but is not available to the
carrier.
(3) Each carrier
shall submit the health care claims data monthly, no later than the last day of
the month following the month in which the carrier adjudicated the
claim.
Notes
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