Uniform Claim Forms Authorized

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  1. The commissioner has the discretion to prescribe by regulation, after due consultation with providers of health care or treatment, accident and sickness insurers, hospital, medical and dental service corporations and other prepayment organizations representative of those organizations, claim forms for reporting by health care providers. The prescribed forms shall include, but need not be limited to, information regarding the medical diagnosis, treatment and prognosis of the patient, together with the details of charges incident to the providing of the care, treatment or services, sufficient for the purpose of meeting the proof requirements of an accident and sickness insurance or hospital, medical or dental service contract.
  2. The adoption of any uniform claim forms by the commissioner pursuant to this section shall not preclude an insurer, hospital, medical or dental service corporation or other prepayment organization from obtaining any necessary additional information regarding a claim from the claimant, provider of health care or treatment, or certifier of coverage.
  3. Any regulation so adopted shall specify an effective date, which shall not be less than twelve (12) months after the date of adoption or promulgation, after which no accident and sickness insurer, hospital, medical or dental service corporation or other prepayment plan may require providers of health care or treatment to complete forms differing from those prescribed by the commissioner pursuant to this section.


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