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.
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