<html> <head> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <style> <!-- --> </style> </head> <body lang=EN-US link=blue vlink=purple> <div> <p align=center><b>CHAPTER 67:16:01</b></p> <p align=center><b>GENERAL PROVISIONS</b></p> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:01">67:16:01:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Definitions.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:02">67:16:01:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Transferred.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:03">67:16:01:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Repealed.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:04">67:16:01:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Choosing a provider.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:05">67:16:01:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Transferred.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:06">67:16:01:06</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Repealed.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:06.01">67:16:01:06.01</a>&nbsp;&nbsp; Covered services.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:06.02">67:16:01:06.02</a>&nbsp;&nbsp; Covered services must be medically necessary.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:06.03">67:16:01:06.03</a>&nbsp;&nbsp; Covered services requiring prior authorization.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:07">67:16:01:07</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; State payment as payment in full -- Individual responsible for payment of noncovered services.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:07.01">67:16:01:07.01</a>&nbsp;&nbsp; Transferred</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:07.02">67:16:01:07.02</a>&nbsp;&nbsp; Transferred.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:08">67:16:01:08</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Services not covered.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:08.01">67:16:01:08.01</a>&nbsp;&nbsp; Sterilization services.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:09">67:16:01:09</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Amount of payment.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:10">67:16:01:10</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Payment of mileage to provider.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:11">67:16:01:11</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Payment made to provider.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:12">67:16:01:12</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Confidential information.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:13">67:16:01:13</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Identification card.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:14">67:16:01:14</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Transferred.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:15">67:16:01:15</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Repealed.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:16">67:16:01:16</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Uniformity of services.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:17">67:16:01:17</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fair hearings.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:18">67:16:01:18</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Civil rights.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:19">67:16:01:19</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Utilization review.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:20">67:16:01:20</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Transferred</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:21">67:16:01:21</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Transferred.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:22">67:16:01:22</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Cost-sharing participants.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:22.01">67:16:01:22.01</a>&nbsp;&nbsp; Services exempt from cost sharing.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:23">67:16:01:23</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Cost sharing deducted from allowable reimbursement before payment.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:24">67:16:01:24</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Application of chapter.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:25">67:16:01:25</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Use of Current Procedural Terminology.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:26">67:16:01:26</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Use of International Classification of Diseases.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:27">67:16:01:27</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Use of Health Care Common Procedure Coding System.</p> <p><a href="DisplayRule.aspx?Rule=67:16:01:28">67:16:01:28</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Rates and procedures subject to review and amendment -- Provider may request review.</p> </div> </body> </html>