South Carolina Code of Regulations
Chapter 67 - SOUTH CAROLINA WORKERS' COMPENSATION COMMISSION
Article 13 - MEDICAL REPORTS, PHYSICIAN'S FEES AND HOSPITAL CHARGES
Section 67-1303 - Payments for Hospital Inpatient Services
Universal Citation: SC Code Regs 67-1303
Current through Register Vol. 48, No. 3, March 22, 2024
A. The Commission shall maintain a prospective payment system based on diagnosis related groups with methodology and prices established by the Commission for the payment of inpatient hospital services.
(1) Hospitals submit claims for
payment to the employer or insurance carrier on the Form 14A.
(2) The Commission recognizes the current
uniform billing (UB) form as its Form 14A for hospitals.
(3) The employer or insurance carrier
reviewing the claim for payment shall be entitled to a copy of the applicable
hospital records at no charge.
B. The Commission may review and revise the prospective payment system as needed.
C. An employer or insurance carrier may not pay, and a hospital may not accept, more than the amount set by the Commission for inpatient hospital services.
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