28 Pa. Code § 911.2. Pennsylvania Uniform Claims and Billing Form format

28 Pa. Code § 911.2. Pennsylvania Uniform Claims and Billing Form format—Statement of Policy.

§ 911.2. Pennsylvania Uniform Claims and Billing Form format—Statement of Policy.

(a)  General requirements. The Pennsylvania Uniform Claims and Billing Form format consists of the UB-92/HCFA 1450 and HCFA 1500, or their successors, and additional elements adopted by the Council. The billing form shall be utilized and maintained by data sources and for services covered by the act for the purposes of maintaining common data and common billing formats.
(b)  Uniform definitions for the Pennsylvania Uniform Claims and Billing Form format. Definitions for use of the Uniform Claims and Billing Form shall be in accordance with the manual developed by the National Uniform Billing Committee and definitions contained in the Council manual number HC-87-101. Definitions in the Council manual HC-87-101 take precedence over National Uniform Billing Committee definitions.
(c)  Patient bill requirements. Beginning November 13, 1987, a provider shall present to a patient a copy of a bill for covered services upon discharge from a health care facility or provision of physician services or within a reasonable time thereafter. When providing a patient with copies of a bill for inpatient or outpatient covered services, a provider may use revenue descriptions and charges contained in the Pennsylvania Uniform Claims and Billing Form format or may itemize the charges for services, equipment, supplies and medicine.

Authority

   The provisions of this §  911.2 amended under the Health Care Cost Containment Act (35 P. S. § §  449.1—449.19).

Source

   The provisions of this §  911.2 adopted August 14, 1987, effective August 15, 1987, 17 Pa.B. 3409; amended October 30, 1987, effective October 31, 1987, 17 Pa.B. 4447; amended July 23, 1993, effective July 24, 1993, 23 Pa.B. 3477. Immediately preceding text appears at serial pages (177650) to (177651).

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