(a) Upon application of a carrier or third-party administrator, the department shall grant a waiver of the requirement to submit a particular data element required under these rules, upon a showing by the carrier or third-party administrator that:
- (1) The data element does not exist on the carrier’s or third-party administrator’s transaction system;
- (2) The data element cannot be derived reliably from other information available on the carrier’s or third-party administrator’s transaction system; and
- (3) The data element does not reflect information necessary to process claims or to conduct business operations in accordance with generally accepted industry standards, such that it should reasonably be available.
- (b) A carrier or third-party administrator granted a waiver shall populate that data field in its claims data submissions in the manner specified in the waiver.
Source. #10877, eff 7-10-15; ss by #13136 eff 11-24-20