Kansas Administrative Regulations
Agency 40 - INSURANCE DEPARTMENT
Article 4 - ACCIDENT AND HEALTH INSURANCE
Section 40-4-40 - Accident and sickness insurance; claim forms; acceptance required

Universal Citation: KS Admin Regs 40-4-40

Current through Register Vol. 43, No. 52, December 26, 2024

(a) As used in this regulation:

(1) "Commissioner" means the commissioner of insurance, state of Kansas.

(2) "Claim form" shall mean any of the forms devised and promulgated by the commissioner pursuant to K.S.A. 1991 Supp. 40-2253.

(3) "Insurer" means insurance companies, health maintenance organizations, mutual nonprofit medical and hospital service corporations, nonprofit dental service corporations, nonprofit optometric service corporations and nonprofit pharmacy service corporations.

(b) Insurers transacting business in this state shall accept and process any claim for benefits designated and submitted on a claim form as defined in subsection (a) of this regulation.

(c) Insurers shall not require health care providers, insureds or other persons to utilize a claim form promulgated by the commissioner if a simplified form will produce the information necessary to process the claim.

(d) This regulation does not prohibit an insurer from requesting additional information from a health care provider when such information is essential to a proper determination of benefit payments.

(e) Claim forms may be modified as necessary to accommodate the transmission and administration of claims by electronic means.

(f) The requirements imposed by this regulation shall take effect and be in force from and after 180 days following the regulation's effective date.

Disclaimer: These regulations may not be the most recent version. Kansas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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