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304.17A-705 Electronic claims submission.
(1) As used in this section, "insurer" has the same meaning as in KRS 304.17A-005. <br>(2) Any contract between an insurer and its pharmacy benefits administrator that
requires claims to be submitted electronically shall require that payment is to be <br>made electronically to the participating provider or its designee for clean claims <br>submitted electronically, if electronic payment is requested by the provider.
(3) Any contract between an insurer and a participating pharmacy or its contracting
agency that requires claims to be submitted electronically shall require that payment <br>is to be made electronically to the participating provider or its designee for clean <br>claims submitted electronically, if electronic payment is requested by the provider.
(4) An electronic claim shall be submitted in the form required by the insurer if the
participating provider or designee agrees to accept claims details for these payments <br>electronically and provides accurate electronic funds transfer information to the <br>insurer.
(5) All electronic claims shall be in compliance with the provisions of 45 C.F.R. Part
142.
(6) The provisions of this section shall apply to all contracts in subsections (2) and (3)
of this section that are entered into, amended, extended, or renewed on or after <br>January 1, 2009.
Effective: July 15, 2008 <br>History: Created 2008 Ky. Acts ch. 40, sec. 1, effective July 15, 2008. <br>Legislative Research Commission Note (7/15/2008). The House Committee Substitute
for 2008 HB 551 intended to change the word "carrier" to "insurer" throughout. One <br>instance of "carrier" at the end of subsection (4) of this statute was inadvertently not <br>changed. This manifest clerical or typographical error has been corrected by the <br>Reviser of Statutes in codifying 2008 Ky. Acts ch. 40, sec. 1, under the authority of <br>KRS 7.136(1)(h).
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