RCW 48.200.250
Evidence of validation of claim.
For purposes of RCW 48.200.210 through 48.200.270, an entity, or an independent third party that contracts with an entity to conduct audits, must allow as evidence of validation of a claim:
(1) An electronic or physical copy of a valid prescription if the prescribed drug was, within fourteen days of the dispensing date:
(a) Picked up by the patient or the patient's designee;
(b) Delivered by the pharmacy to the patient; or
(c) Sent by the pharmacy to the patient using the United States postal service or other common carrier;
(2) Point of sale electronic register data showing purchase of the prescribed drug, medical supply, or service by the patient or the patient's designee; or
(3) Electronic records, including electronic beneficiary signature logs, electronically scanned and stored patient records maintained at or accessible to the audited pharmacy's central operations, and any other reasonably clear and accurate electronic documentation that corresponds to a claim.
[ 2020 c 240 § 12; 2014 c 213 § 7. Formerly RCW 19.340.070.]
Structure Revised Code of Washington
Chapter 48.200 - Health Care Benefit Managers.
48.200.030 - Registration requirements—Application—Fees—Retention of transaction records.
48.200.210 - Definitions applicable to RCW 48.200.220 through 48.200.290.
48.200.220 - Auditing of claims—Requirements—Prohibited practices.
48.200.230 - Basis of finding of claim.
48.200.240 - Contract with third party—Prohibited practices.
48.200.250 - Evidence of validation of claim.
48.200.280 - Predetermination of reimbursement costs—Appeals—Review by commissioner.
48.200.290 - Enforcement—Disputes—Civil penalties.