GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1993

H	1 

HOUSE BILL 5

Short Title:  Std. Health Claims Form.	(Public)
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Sponsors: Representatives Gamble, Green; Bowman, Joye, Luebke, Flaherty, Gray, Oldham, Gottovi, Black, Dockham, Wilkins, Wright, Esposito, Justus, and Hightower.
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Referred to:  Health and Human Services.
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January 28, 1993

A BILL TO BE ENTITLED
AN ACT TO REQUIRE THE DEVELOPMENT AND USE OF A STANDARD CLAIMS FORM FOR HEALTH INSURANCE REIMBURSEMENT CLAIMS.
The General Assembly of North Carolina enacts:
Section 1. Effective October 1, 1993,  G.S. 58-50-10 reads as rewritten:
"§ 58-50-10.  Claim forms.
(a)	All forms used by policyholders, beneficiaries, hospitals and physicians to report information relative to the nature and extent of loss or disability for which claim is being made under any type of accident or health policy must conform to certain standard language approved by the Commissioner.
(b)	The Commissioner shall prescribe, and all insurers providing health insurance in this State shall accept, a standard claims form to be submitted by health care providers, or by persons receiving services, as appropriate, for reimbursement for health care services provided or received.  To the extent possible, the form shall be a single-page form and shall be designed to provide all of the information necessary for the claim to be paid as soon as possible upon receipt of the completed form by the insurer. An insurer may request from the provider or from the insured additional claim-related information, but the insurer may not delay payment of that claim pending receipt of the additional information.  Nothing in this subsection shall be construed to prohibit an insurer or State agency from accepting any other health insurance claim form for services provided or received, provided that such form meets the requirements of subsection (a) of this section."
Sec. 2. This act is effective upon ratification.