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KRS 304.17A-705

Electronic claims submission

Effective: July 15, 2008 History: Created 2008 Ky

(1) As used in this section, "insurer" has the same meaning as in KRS 304.17A-005.

(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 made electronically to the participating provider or its designee for clean claims 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 is to be made electronically to the participating provider or its designee for clean 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 electronically and provides accurate electronic funds transfer information to the 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 January 1, 2009.

Official source: Kentucky General Assembly. Reproduced from public-domain Kentucky statutes; confirm against the official source for the current text. Not legal advice.