California Code of Regulations
Title 22 - Social Security
Division 7 - Health Planning and Facility Construction
Chapter 10 - Health Facility Data
Article 8 - Patient Data Reporting Requirements
Section 97232 - Definition of Data Element for Inpatients-Expected Source of Payment
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
Effective with discharges on or after January 1, 1999, the patient's expected source of payment -- the entity or organization which is expected to pay or did pay the greatest share of the patient's bill -- shall be reported using the following:
(1) Payer Category. Select one of the following:
(2) Type of Coverage. For each Payer Category, Subsections (1)(A) through (1)(F) of this section, select one of the following Types of Coverage:
(3) Health Plan Identification Number. If Type of Coverage is reported as category (A) above, report the specific plan providing coverage by listing the four digit health plan identification number assigned by the California Department of Managed Health Care (DMHC). If Type of Coverage is reported as category (A) above and if the health plan has a pending Knox-Keene license application with DMHC or if the health plan is a COHS that does not have a DMHC assigned number, the four digit health plan identification number shall be reported as 8000.
1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42).
2. Amendment filed 7-23-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 30).
3. Amendment of section, including new subsection (a)(3)(A), filed 9-21-98; operative 10-21-98 (Register 98, No. 39).
4. Editorial correction of HISTORY 3 (Register 2000, No. 20).
5. Change without regulatory effect repealing subsections (a)-(a)(14), renumbering subsections, amending newly designated subsections (a)(1)(F), (a)(1)(G), (a)(1)(I), (a)(2), (a)(2)(B) and (a)(3)(A), and adopting new subsection (a)(2)(B) filed 5-17-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 20).
6. Change without regulatory effect repealing subsection (a)(3)(A), relettering subsections, amending newly designated subsection (a)(3)(A) and adopting new subsection (a)(3)(B) filed 3-8-2004 pursuant to section 100, title 1, California Code of Regulations (Register 2004, No. 11).
7. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section 11343.4 (Register 2005, No. 18).
8. Change without regulatory effect amending subsection (a)(1)(C), repealing subsection (a)(3)(A), relettering former subsection (a)(3)(B) to new subsection (a)(3)(A) and adopting new subsection (a)(3)(B) filed 8-11-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 32).
9. Amendment filed 12-31-2009; operative 12-31-2009 pursuant to Government Code section 11343.4 (Register 2010, No. 1).
10. Change without regulatory effect amending section filed 7-21-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 30).
11. Change without regulatory effect amending subsection (3) -- Table 1 filed 8-23-2011 pursuant to section 100, title 1, California Code of Regulations (Register 2011, No. 34).
12. Change without regulatory effect amending subsection (3) -- Table 1 filed 12-28-2011 pursuant to section 100, title 1, California Code of Regulations (Register 2011, No. 52).
13. Change without regulatory effect amending subsection (3) -- Table 1 filed 3-25-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 13).
14. Change without regulatory effect amending first paragraph, subsections (1) and (3) and subsection (3) -- Table 1 filed 9-23-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 39).
15. Change without regulatory effect amending subsection (3) -- Table 1 filed 8-5-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 32).
16. Change without regulatory effect amending subsection (3) and Table 1 filed 4-30-2015 pursuant to section 100, title 1, California Code of Regulations (Register 2015, No. 18).
17. Change without regulatory effect amending Table 1 in subsection (3) filed 3-17-2016 pursuant to section 100, title 1, California Code of Regulations (Register 2016, No. 12).
18. Change without regulatory effect amending subsections (1)(F)-(2), (2)(B) and (3) filed 2-8-2018 pursuant to section 100, title 1, California Code of Regulations (Register 2018, No. 6).
19. Editorial correction of subsection (3) -- Table (Register 2018, No. 12).
20. Change without regulatory effect amending subsections (1) and (3) filed 10-31-2018 pursuant to section 100, title 1, California Code of Regulations (Register 2018, No. 44).
21. Change without regulatory effect amending subsections (2)(A) and (3) filed 5-2-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 18).
22. Change without regulatory effect amending subsections (2)(A)-(B) and (3) filed 9-23-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 39).
Note: Authority cited: Section 128810, Health and Safety Code. Reference: Section 128735, Health and Safety Code.