Uniform claims forms

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    (a)    (1)    In this section the following words have the meanings indicated.

        (2)    “Third party payor” means any person that administers or provides reimbursement for hospital benefits on an expense incurred basis including:

            (i)    A health maintenance organization issued a certificate of authority in accordance with Subtitle 7 of this title;

            (ii)    A health insurer or nonprofit health service plan authorized to offer health insurance policies or contracts in this State in accordance with the Insurance Article; or

            (iii)    A third party administrator registered under the Insurance Article.

        (3)    “Uniform claims form” means the claim or billing form for reimbursement of hospital services adopted by the Insurance Commissioner under § 15-1003 of the Insurance Article.

    (b)    When submitting a claim or bill for reimbursement to a third party payor, a hospital shall use the uniform claims form.

    (c)    The uniform claims form submitted under this section:

        (1)    Shall be properly completed; and

        (2)    May be submitted by electronic transfer.

    (d)    The Secretary may impose a penalty not to exceed $500 on any hospital that violates the provisions of this section.


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