1. (a) Except as provided by §134.801 of this title (relating to Submitting Medical Bills for Payment), health care providers shall submit medical bills for payment on standard forms used by the Centers for Medicare and Medicaid Services (CMS) or applicable forms prescribed in subsections (b) and (c), completed in accordance with Commission instructions. All information on medical bills shall be legible when submitted.
2. (b) Except as provided in subsections (c), and (d) of this section, all health care providers, as defined in §401.011 of the Texas Labor Code, shall submit medical bills using national standard health insurance claim forms, prepared according to Commission instructions.
3. (c) Pharmacists shall submit bills using the Commission form TWCC-66, Statement for Pharmacy Services, prepared according to Commission instructions.
4. (d) Dentists shall submit bills using a billing form currently approved by the American Dental Association prepared according to Commission instructions.
5. (e) Health care providers may submit medical bills by facsimile or electronic transmission, when mutually agreed upon between the health care provider and the insurance carrier, unless the bill and/or supporting documentation cannot be sent by those media, in which case the health care provider shall send the documentation by mail or personal delivery.
6. (f) The Medical Review Division may order the health care provider to reimburse a carrier when the carrier pays the health care provider in excess of the amount allowed by the appropriate Commission fee guideline.
7. (g) This rule shall apply to all dates of service on or after September 1, 2004.

Source Note:The provisions of this §134.800 adopted to be effective February 20, 1991, 16 TexReg 671; amended to be effective June 1, 1992, 17 TexReg 3250; amended to be effective July 15, 2000, 25 TexReg 2139; amended to be effective July 11, 2004, 29 TexReg 6303.