ARSD 67:16:35:01. Definitions

Terms used in this chapter mean: (1) "Adjustment/void claim form," a form that is used to adjust or void a previously paid claim; (2) "Cross-over claim form," a form used to record the Medicare co-insurance and deductible payments for recipients who are eligible for both Medicare and Medicaid; (3) "Denied claim," a claim that does not qualify for a medical assistance payment; (4) "Pended claim," a claim which has not been paid or denied but is being reviewed for final action; and (5) "Remittance advice," a document sent to the provider which contains the status of claims submitted by that provider.