The provider must reconcile the remittance advice with the patient's records. The department shall send a warrant with the remittance advice when the amount of a check is indicated on the remittance advice. The provider must retain the remittance advice according to § 67:16:34:05. Claims to be resubmitted for payment must meet the requirements of § 67:16:35:15.

When the department denies or pends a claim, the remittance advice shall contain the specific reason the claim was denied or pended.

Source: 17 SDR 184, effective June 6, 1991; 19 SDR 165, effective May 3, 1993.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.