§ 58-3-171. Uniform claim forms. - North Carolina Statutes

§ 58‑3‑171. Uniform claim forms.

(a)        All claimssubmitted by health care providers to health benefit plans shall be submittedon a uniform form or format that shall be developed by the Department andapproved by the Commissioner. Additional information beyond that contained onthe uniform form or format may be collected subject to rules adopted by theCommissioner. This section applies to the submission of claims in writing andby electronic means.

(b)        After consultationwith the North Carolina Industrial Commission, the Commissioner may includeworkers' compensation insurance policies as "health benefit plans"for the purpose of administering the provisions of this section.

(c)        For purposes ofthis section, "health benefit plans" means accident and health insurancepolicies or certificates; nonprofit hospital or medical service corporationcontracts; health maintenance organization (HMO) subscriber contracts and otherplans provided by managed‑care organizations; plans provided by a MEWA orplans provided by other benefit arrangements, to the extent permitted by ERISA;the State Health Plan for Teachers and State Employees and any optional plansor programs operating under Part 2 of Article 3 of Chapter 135 of the GeneralStatutes; and medical payment coverages under homeowners and automobileinsurance policies. (1993, c. 529, s. 4.2; 2007‑298, s. 8.2; 2007‑323, s.28.22A(o); 2007‑345, s. 12.)