The division shall pay the provider after receiving the following pertinent billing information:

1. (1) A completed, standardized billing form;
2. (2) An itemized statement of preauthorized services rendered; and

3. (3) An insurance deduction or rejection shown on the billing form with an attached explanation of benefits from the insurance plan.

   This information must be received by the division no later than six months from the service date.

Source: 32 SDR 32, effective August 29, 2005.

General Authority: SDCL 49-31-50.2.

Law Implemented: SDCL 49-31-50 , 49-31-50.1 , 49-31-51.