S.D. Admin. R. 67:16:35:01

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:16:35:01 - Definitions

Terms used in this chapter mean:

(1) "Adjustment/void claim form," a form that is used to adjust or void a previously paid claim;

(2) "Cross-over claim form," a form used to record the Medicare co-insurance and deductible payments for recipients who are eligible for both Medicare and Medicaid;

(3) "Denied claim," a claim that does not qualify for a medical assistance payment;

(4) "Pended claim," a claim which has not been paid or denied but is being reviewed for final action; and

(5) "Remittance advice," a document sent to the provider which contains the status of claims submitted by that provider.

S.D. Admin. R. 67:16:35:01

17 SDR 4, effective 7/16/1990; 17 SDR 184, effective 6/6/1991; 26 SDR 168, effective 7/1/2000.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.