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

Utah Admin. Code R428-15-4
Amended by Utah State Bulletin Number 2016-8, effective 3/25/2016 Amended by Utah State Bulletin Number 2025-03, effective 1/15/2025

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