11 NCAC 12 .1509             PATIENT SUBMITTED CLAIM FORMS

The health care provider shall provide a patient the CMS-1500 and UB-04 (CMS-1450) standard claim forms, if the patient must submit a claim to a payor. The standard claim form shall be provided as the initial bill for payment of services and shall be used by the patient to request reimbursement from a payor. Health care providers shall also continue to provide patients billing statements for subsequent billing of the same services. A payor shall not require any additional documentation from a patient to support a claim for reimbursement payment by a patient if the information required is already contained on the standard claim form. No payor shall require any patient to submit claims or other information in an electronic format.

History Note:        Authority G.S. 58‑2‑40; 58‑3‑171;

Eff. October 1, 1994;

Readopted Eff. May 1, 2020.