11 NCAC 12 .1507             ATTACHMENT FORM OR FORMAT

(a)  As used in this Rule, "attachment form or format" means a form, document, or communication of any kind used by a payor to request additional information other than that contained on the standard claim form, from a health care provider, in connection with processing a claim for payment.

(b)  Effective January 1, 1995, no additional attachment forms or formats may be used except as authorized by this Section.  Payors may use local use blocks on the standard claim form or obtain prior approval from the Commissioner to use other information in addition to that contained in the standard claim form.

(c)  All attachment forms or formats in use on October 1, 1994, must be submitted by payors to the Commissioner for registration on or before January 1, 1995, and may continue to be used thereafter if they are in compliance with this Section.  Payors may not require the submission of information already contained in the standard claim form, or any other information not necessary for the processing of a claim.  After January 1, 1995, no additional attachments shall be used unless filed with and approved by the Commissioner.  All additional attachments shall be reviewed by the SUBC, which shall make a recommendation to the Commissioner for final consideration.

(d)  After consideration and approval by the SUBC, the SUBC may recommend to the Commissioner any changes to the standard claim form once every calendar year quarter beginning January 1, 1995.


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

Eff. October 1, 1994.