KRS 304.17A-705: Electronic claims submission.

(1) As used in this section, "insurer" has the same meaning as in KRS 304.17A-005.

(2) Any contract between an insurer and its pharmacy benefits administrator that

requires claims to be submitted electronically shall require that payment is to be

made electron ically to the participating provider or its designee for clean claims

submitted electronically, if electronic payment is requested by the provider.

(3) Any contract between an insurer and a participating pharmacy or its contracting

agency that requires claims to be submitted electronically shall require that payment

is to be made electronically to the participating provider or its designee for clean

claims submitted electronically, if electronic payment is requested by the provider.

(4) An electronic claim shall be submitted in the form required by the insurer if the

participating provider or designee agrees to accept claims details for these payments

electronically and provides accurate electronic funds transfer information to the

insurer.

(5) All electronic claims shall be in compliance with the provisions of 45 C.F.R. Part

142.

(6) The provisions of this section shall apply to all contracts in subsections (2) and (3)

of this section that are entered into, amended, extended, or renewed on or after

January 1, 2009.