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31.10.12.00.htm 31.10.12.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 10 HEALTH INSURANCE ― GENERAL Chapter 12 Uniform Consultation Referral Authority: Insurance Article, §2-109 and 15-120, Annotated Code of Maryland
31.10.12.01.htm 31.10.12.01. 01 Applicability and Scope.. This chapter is applicable to all:. A. Carriers as defined in Regulation .02B(1) of this chapter;. B. Consultant/facility providers as defined in Regulation .02B(2) of this chapter; and. C. Primary or requesting providers as defined in Regulation .02B(4) of this chapter..
31.10.12.02.htm 31.10.12.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Carrier" means:. a) An insurer;. b) A nonprofit health service plan;. c) A health maintenance organization; or. d) A dental plan organization.. 2) “Consultant/facility provider” means:. a) A person licensed or certified under Health Occupations Article, Annotated Code of Maryland, who receives a referral from a primary or requesting provider; or
31.10.12.03.htm 31.10.12.03. 03 Uniform Consultation Referral Form ― Carrier Requirements.. A. If a carrier requires a covered person to have a written referral in order to receive services, the carrier shall use the uniform consultation referral form as defined in Regulation .02B(6) of this chapter.B. The carrier may not impose as a condition of coverage a requirement to:. 1) Modify the uniform consultation referral form, except as provided in E of this regulation; or.
31.10.12.04.htm 31.10.12.04. 04 Uniform Consultation Referral Form ― Primary or Requesting Provider.. A. The primary or requesting provider shall use the uniform consultation referral form as defined in Regulation .02B(6) of this chapter and instructions as provided in Regulation .03C of this chapter.B. The uniform consultation referral form shall be properly completed by the primary or requesting provider.
31.10.12.05.htm 31.10.12.05. 05 Uniform Consultation Referral Form ― Consultant/Facility Provider.. The consultant/facility provider shall accept a properly completed uniform consultation referral form.
31.10.12.06.htm 31.10.12.06. 06 General Provisions.. A. The requirements under these regulations do not apply to an entity that would be using a consultation form solely for internal purposes.B. The Maryland Uniform Consultation Referral Form shall read as follows:. C. The electronic equivalent of the uniform consultation referral form is as follows:. Electronic Equivalent of the Uniform Consultation Referral Form. Field. Length. Start. Stop. 1 - Patient last name. 18. 2 - Patient first name. 8. 32. 39.
31.10.12.07.htm 31.10.12.07. 07 Electronic Transfer of the Uniform Consultation Referral Form.. A. A transmission by facsimile is not considered an electronic transfer for the purposes of this chapter.B. A carrier shall accept the electronic transfer of the uniform consultation referral form..
31.10.12.08.htm 31.10.12.08. 08 Uniform Consultation Referral Form ― Required Forms.. A. The Maryland Uniform Dental Consultation Referral Form shall read as follows:. B. The electronic equivalent of the uniform consultation referral form is as follows:. Uniform Dental Consultation Referral. Field. Length. Start. Stop. 1 - Patient last name. 18. 2 - Patient first name. 12. 19. 30. 3 - Patient MI. 4 - Patient DOB. 8. 32. 39. 5 - Patient phone number. 10. 40. 49. 6 - Patient member number. 16. 50. 65.
31.10.12.9999.htm 31.10.12.9999. Administrative History Effective date: October 21, 1996 (23:21 Md. R. 1467). Regulation .03 amended as an emergency provision effective January 28, 1997 (24:4 Md. R. 289) adopted permanently effective May 19, 1997 (24:10 Md. R. 710)Regulation .07 adopted as an emergency provision effective January 28, 1997 (24:4 Md. R. 289) adopted permanently effective May 19, 1997 (24:10 Md. R. 710) ―Chapter recodified from COMAR 09.31.23 to COMAR 31.10.12, July 1998. Regulation .02B amended e
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