When a provider has requested payment of a claim and the department has documentable reason to believe that a possible third-party payment source exists, the department shall deny the claim unless it is covered under the provisions of § 67:16:26:07.02. Claims denied under this section may not be resubmitted until the conditions of § 67:16:26:05 have been met.

Source: 7 SDR 23, effective September 18, 1980; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 226, effective June 24, 1990.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.