Health Insurance Claims Administration Rule

Thursday, April 1, 2010

Establishes a process for the creation of uniform standards, including electronic transaction standards, for health insurance claims administration and adjudication, including but not limited to standards relating to claims forms, patient invoices and explanation of benefits forms, the use of payment codes, claims submission and processing procedures, and the prior authorization process.

REG-H-2008-04.pdf223.2 KB
Sample Doctor Bill31.45 KB
Sample Hospital Bill63.83 KB
Sample EOB23.42 KB

These documents are not legal documents but are placed here for reference purposes only. For a legal copy please contact the department.