Terms used in this chapter mean:
- (1) "Adjustment/void claim form," a form that is used to adjust or void a previously paid claim;
- (2) "Cross-over claim form," a form used to record the Medicare co-insurance and deductible payments for recipients who are eligible for both Medicare and Medicaid;
- (3) "Denied claim," a claim that does not qualify for a medical assistance payment;
- (4) "Pended claim," a claim which has not been paid or denied but is being reviewed for final action; and
- (5) "Remittance advice," a document sent to the provider which contains the status of claims submitted by that provider.
Source: 17 SDR 4, effective July 16, 1990; 17 SDR 184, effective June 6, 1991; 26 SDR 168, effective July 1, 2000.
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.