Utah Admin. Code R590-164-2 - Purpose and Scope
(1) The purpose of
this rule is to designate uniform claim forms, billing codes, and compatible
electronic data interchange standards for use by health payers and providers.
(2) This rule applies to a health
claim, a health encounter, and any electronic data interchange between a payer
and a provider.
(3) Except as
otherwise specifically provided, this rule applies to a payer and a
provider.
(4) This rule does not
prohibit a payer from requesting additional information to determine
eligibility of a claim under the terms of the policy or certificate issued to
the claimant.
(5) This rule does
not prohibit a payer or provider from using alternative forms or procedures
specified in a written contract between the payer and provider.
(6) This rule does not exempt a payer or
provider from data reporting requirements under state or federal law or
regulation.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.