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304.14-135 Uniform health insurance claim forms.
(1)
(2)
The commissioner shall prescribe the following uniform health insurance claim
forms which shall be used by all insurers transacting health insurance in this
state and by all state agencies that require health insurance claim forms for
their records as the sole instrument for reimbursement:
(a) The uniform health insurance claim form for an institutional provider shall
consist of the UB-92 data set or its successor submitted on the
designated paper or electronic format as adopted by the National Uniform
Billing Committee;
(b) The uniform health insurance claim form for a dentist shall consist of a
data set and form approved by the American Dental Association;
(c) The uniform health insurance claim form for all other health care
providers shall consist of the HCFA 1500 data set or its successor
submitted on the designated paper or electronic format as adopted by the
National Uniform Claims Committee; and
(d) A clean claim for pharmacists shall consist of a universal claim form or
data set approved by the National Council on Prescription Drug Program.
An insurer shall not require a provider to:
(a) Use a claim form that is different than the uniform claim form for the
provider type as set out in subsection (1) of this section;
(b) Modify the uniform claims form or its content; or
(c) Submit additional claims forms.
Effective:July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1152, effective July 15, 2010. -Amended 2000 Ky. Acts ch. 436, sec. 18, effective July 14, 2000. -- Created
1980 Ky. Acts ch. 8, sec. 1, effective July 1, 1982.
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