South Dakota Codified Laws
Chapter 12 - Insurance Claims And Benefits
Section 58-12-12 - Use of uniform health insurance claim forms.

58-12-12. Use of uniform health insurance claim forms.
The director shall prescribe the use of nationally recognized uniform health insurance claim forms for hospitals and other medical or dental providers and for governmental agencies which shall be used and accepted by all insurers transacting health insurance, providing medical coverage through a personal automobile policy, workers' compensation, or otherwise providing coverage for medical services and by all hospitals and medical providers, and by governmental agencies of the state that require insurance claim forms for their records. The director shall also prescribe the use of nationally recognized uniform explanation of benefit forms by insurers.

Source: SL 1994, ch 381, §5.

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Structure South Dakota Codified Laws

South Dakota Codified Laws

Title 58 - Insurance

Chapter 12 - Insurance Claims And Benefits

Section 58-12-1 - Forms for proof of loss--Furnishing by insurer on request.

Section 58-12-2 - Acts of insurer not constituting waiver of policy provision or defense.

Section 58-12-3 - Attorney fees--Recovery in action against self-insured employer or insurer failing to pay loss--Other remedies not barred.

Section 58-12-3.1 - Separate hearing on attorney fees--Adding to judgment--Time allowed to request hearing.

Section 58-12-4 - Life and health insurance--Exemption of benefits and proceeds from execution.

Section 58-12-5 - "Annuity contract" defined.

Section 58-12-6 - Exemption of annuity contract benefits, rights, privileges, and options from execution.

Section 58-12-7 - Premiums paid on annuity with intent to defraud creditors not exempt from execution.

Section 58-12-8 - Maximum amount of annuity exemption--Excess subject to levy.

Section 58-12-9 - Application of excess annuities to judgment--Factors considered.

Section 58-12-10 - Benefits, rights, privileges, or options nontransferable under annuity contract--Not subject to commutation--Exemption from execution.

Section 58-12-11 - Payments under life or health insurance policy or annuity contract discharge insurer.

Section 58-12-12 - Use of uniform health insurance claim forms.

Section 58-12-13 - Use of claim forms required by federal law excepted.

Section 58-12-14 - Promulgation of rules for uniform health insurance claim forms.

Section 58-12-15 - "Paintless dent repair" defined.

Section 58-12-16 - Motor vehicle insurer must provide sufficient compensation to restore vehicle to prior condition--Adjustment for paintless dent repair permitted--Conditions.

Section 58-12-17 - Compensation when paintless dent repair method inappropriate--Requiring unreasonable travel prohibited--Repair shop as payee only if insured agrees.

Section 58-12-18 - Compliance with § 58-12-16.

Section 58-12-19 - Clean claim defined.

Section 58-12-20 - Time limits for processing clean claims--Time limit for additional information required.

Section 58-12-21 - Applicability of §§ 58-12-19 to 58-12-21--Certain policies exempt--No private right of action.

Section 58-12-22 - Information from insurer's database to Department of Social Services--Data match against recipients--Disclosure--Liability.

Section 58-12-23 - Application for or acceptance of medical assistance paid by department operates as release of information to facilitate coordination of benefits--Request.

Section 58-12-24 - Refusal of reimbursement due to manner, form, or date of claim prohibited--Time for submission of claim.

Section 58-12-25 - Reimbursement to department for cost of services.

Section 58-12-26 - Insurer defined.

Section 58-12-27 - Department defined.

Section 58-12-28 - Provisions of chapter 1-27 not applicable to insurer records.

Section 58-12-30 - Annual reports of commercial property casualty insurance claims--Exception--Promulgation of rules.

Section 58-12-31 - Definitions regarding standards for claims processing.

Section 58-12-32 - Application of standards for claims investigation and disposition.

Section 58-12-33 - Flagrant or frequent violations--Notice and opportunity to correct inadvertent violations.

Section 58-12-34 - Acts constituting unfair claims practices.

Section 58-12-35 - Notice of hearing.

Section 58-12-36 - Cease and desist order--Monetary penalty--Suspension or revocation of license.

Section 58-12-37 - Promulgation of rules regarding definitions and records.