Definitions relative to electronic medical bills for workers' compensation claims.

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34:15-143 Definitions relative to electronic medical bills for workers' compensation claims.

1. As used in this act:

"Complete electronic medical bill" means a medical bill that meets all of the following criteria: (1) it is submitted in the correct uniform billing format, with the correct uniform billing code sets, transmitted in compliance with the guidelines; (2) the bill and electronic attachments provide all information required pursuant to this act; and (3) the health care provider, its billing representative, or any company that has purchased the rights to pursue its bill has provided all information that the employer, employer's insurance carrier, or workers' compensation third party administrator requested.

"Electronic bill" means a communication between computerized data exchange systems that complies with the guidelines enumerated.

"Guidelines" means the format established by the Commissioner of Labor and Workforce Development in consultation with the Commissioner of Banking and Insurance pursuant to this act, which shall be based upon the International Association of Industrial Accident Boards and Commissions (IAIABC) Workers' Compensation Electronic Medical Billing Rule and Companion Guide.

L.2016, c.64, s.1.


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