407‑120‑0100
Definitions 407‑120‑0110
Purpose 407‑120‑0112
Scope and Sequence of Electronic Data Transmission Rules 407‑120‑0114
Provider Enrollment Agreement 407‑120‑0116
Web Portal Submitter 407‑120‑0118
Conduct of Direct Data Entry Using Web Portal 407‑120‑0120
Registration Process — EDI Transactions 407‑120‑0130
Trading Partner as EDI Submitter – EDI Transactions 407‑120‑0140
Trading Partner Agents as EDI Submitters — EDI Transactions 407‑120‑0150
Testing — EDI Transactions 407‑120‑0160
Conduct of Transactions — EDI Transactions 407‑120‑0165
Pharmacy Point of Sale Access 407‑120‑0170
Confidentiality and Security 407‑120‑0180
Record Retention and Audit 407‑120‑0190
Material Changes 407‑120‑0200
Department System Administration 407‑120‑0300
Definitions 407‑120‑0310
Provider Requirements 407‑120‑0320
Provider Enrollment 407‑120‑0325
Compliance with Federal and State Statutes 407‑120‑0330
Billing Procedures 407‑120‑0340
Claim and PHP Encounter Submission 407‑120‑0350
Payments and Overpayments 407‑120‑0360
Consequences of Non-Compliance and Provider Sanctions 407‑120‑0370
Requirements for Financial, Clinical, and Other Records 407‑120‑0380
Fraud and Abuse 407‑120‑0400
MMIS Replacement Communication Plan 407‑120‑1505
Provider and Contractor Audits, Appeals, and Post Payment Recoveries
Definitions 407‑120‑0110
Purpose 407‑120‑0112
Scope and Sequence of Electronic Data Transmission Rules 407‑120‑0114
Provider Enrollment Agreement 407‑120‑0116
Web Portal Submitter 407‑120‑0118
Conduct of Direct Data Entry Using Web Portal 407‑120‑0120
Registration Process — EDI Transactions 407‑120‑0130
Trading Partner as EDI Submitter – EDI Transactions 407‑120‑0140
Trading Partner Agents as EDI Submitters — EDI Transactions 407‑120‑0150
Testing — EDI Transactions 407‑120‑0160
Conduct of Transactions — EDI Transactions 407‑120‑0165
Pharmacy Point of Sale Access 407‑120‑0170
Confidentiality and Security 407‑120‑0180
Record Retention and Audit 407‑120‑0190
Material Changes 407‑120‑0200
Department System Administration 407‑120‑0300
Definitions 407‑120‑0310
Provider Requirements 407‑120‑0320
Provider Enrollment 407‑120‑0325
Compliance with Federal and State Statutes 407‑120‑0330
Billing Procedures 407‑120‑0340
Claim and PHP Encounter Submission 407‑120‑0350
Payments and Overpayments 407‑120‑0360
Consequences of Non-Compliance and Provider Sanctions 407‑120‑0370
Requirements for Financial, Clinical, and Other Records 407‑120‑0380
Fraud and Abuse 407‑120‑0400
MMIS Replacement Communication Plan 407‑120‑1505
Provider and Contractor Audits, Appeals, and Post Payment Recoveries