KRS 304.17A-704: Insurer's acknowledgment of receipt of claim -- Inaccurate or

insufficient claim information -- Claim status information.

(1) (a) Within forty -eight (48) hours of receiving an original or corrected claim

submitted electronically, an insurer, its a gent, or designee shall acknowledge

the date of receipt of the claim by an electronic transmission to the provider,

its billing agent, or designee that submitted the claim; and

(b) Within twenty (20) calendar days of receipt of an original or corrected cla im

submitted by mail or other nonelectronic means, an insurer, its agent, or

designee shall acknowledge the date of receipt of the claim to the provider, its

billing agent, or designee that submitted the claim.

1. For claims containing all necessary inform ation and having no errors,

the insurer shall make available confirmation of receipt of the claim to

the provider, its billing agent, or designee that submitted the claim.

Acknowledgment may be in writing or the insurer, its agent, or designee

may list the claim and the date it was received on a file that can be

accessed electronically by the provider, its agent, or designee.

2. Claims that contain errors or lack necessary information shall be

acknowledged by an electronic transmission or in writing to the

provider, its billing agent, or designee that submitted the claim.

(2) At the time of acknowledgment under paragraph (a) or (b) of subsection (1) of this

section, an insurer, its agent, or designee, shall notify the provider, its billing agent,

or designee that submitted the claim, in writing or electronically, of all information

that is missing from the billing instrument, any errors in the billing instrument, or of

any other circumstances which preclude it from being a clean claim.

(3) When an insurer, it s agent, or designee has notified a provider, its billing agent, or

designee that submitted the claim, that a claim contains errors, upon receipt of a

corrected clean claim the insurer shall adjudicate the corrected clean claim within

the applicable claims payment time frame for a clean claim established in KRS

304.17A-702.

(4) By January 1, 2001, an insurer shall have in place a mechanism to inform providers

of the status of a claim either through:

(a) Notation on the remittance; or

(b) By allowing provide rs to check claim status electronically at any time

following submission of the claim to the insurer.