31.10.11.01

.01 Applicability and Scope.

A. This chapter is applicable to all:

(1) Claims submitted to third-party payors as defined in Regulation .02B(22) of this chapter;

(2) Claims submitted by health care practitioners as defined in Regulation .02B(12) of this chapter;

(3) Claims submitted by hospitals as defined in Health-General Article, §19-301(g), Annotated Code of Maryland; and

(4) Claims submitted by other persons entitled to reimbursement from a third-party payor who submit claims to third-party payors on the HCFA Form 1500 or HCFA Form UB-92.

B. This chapter is not applicable to claims submitted by members.