N.D. Admin Code 92-01-02-45.2 - Medical service provider electronic billing responsibilities
Medical service providers shall submit electronic medical bills and supporting documentation to the organization unless the health care provider is exempt.
1. A medical
service provider is exempt from the requirement of electronic submission of
medical bills if:
a. The provider submits
fewer than fifty bills per calendar year; or
b. The provider can sufficiently demonstrate
electronic medical bill implementation will create an unreasonable financial
hardship and can provide supporting documentation, such as financial statements
or other documentation which reflect the financial hardship. The exemption
process must be initiated by the medical service provider. Granting an
exemption lies solely within the organization's discretion and is not subject
to appeal.
2. The
organization shall identify and maintain an electronic billing source to enable
the transaction of these services.
3. All medical service providers shall submit
the most current version of the following electronic medical bill processing
standards:
a. Professional billing - ASC X12
837P;
b. Institutional/hospital
billing - ASC X12 837I; or
c.
Dental billing - ASC X12 837D.
Notes
General Authority: NDCC 65-02-08, 65-05-07
Law Implemented: NDCC 65-02-20, 65-05-07, 65-05-07.3
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