20-2320
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20-2320. Exchange of information A. By January 1, 1995, but no sooner than twelve months after approval of a form by the American national standards institute, an accountable health plan shall receive twenty-five per cent of its claim submissions from providers by electronic means in a form approved by the American national standards institute. By January 1, 1997, but no sooner than thirty-six months after approval of a form by the American national standards institute, an accountable health plan shall receive fifty per cent of its claim submissions by electronic means. B. By January 1, 1995, but no sooner than twelve months after approval of a form by the American national standards institute, an accountable health plan shall remit twenty-five per cent of its claim payments to providers by electronic means in a form approved by the American national standards institute. By January 1, 1997, but no sooner than thirty-six months after approval of a form by the American national standards institute, an accountable health plan shall remit fifty per cent of its claim payments by electronic means. C. By January 1, 1995, but no sooner than twelve months after approval of a form by the American national standards institute, an accountable health plan shall conduct twenty-five per cent of its eligibility verification transactions with providers by electronic means in a form approved by the American national standards institute. By January 1, 1997, but no sooner than thirty-six months after approval of a form by the American national standards institute, an accountable health plan shall conduct fifty per cent of its eligibility verifications by electronic means. D. The percentage requirements under this section shall be determined based on the numerical volume rather than on the monetary volume of claims. |