S.D. Admin. R. 44:06:05:01

Current through Register Vol. 51, page 67, December 16, 2024

Section 44:06:05:01 - Billing procedures

The CSHS program shall pay the provider for authorized services rendered after receiving pertinent billing information as follows:

(1) A completed standardized billing form received within one year from the service date; and

(2) An insurance deduction or rejection shown on the billing form with an attached explanation of benefits from the insurance plan, or if a prescription drug claim, a completed CSHS prescription drug claim form allowing the pharmacy to bill CSHS without an explanation of benefits form.

S.D. Admin. R. 44:06:05:01

6 SDR 93, effective 7/1/1980; 14 SDR 182, effective 7/11/1988; 20 SDR 91, effective 12/19/1993; 30 SDR 198, effective 6/23/2004; 33 SDR 106, effective 12/26/2006; 34 SDR 93, effective 10/17/2007.

General Authority: SDCL 34-1-21.

Law Implemented: SDCL 34-1-21.