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Part 2.7. Medical Claims Data Error Correction - California Civil Code Section 57

57.  (a) A qualified entity, as defined in Section 1395kk(e)(2) of
Title 42 of the United States Code, that receives claims data from a
health care service plan or health insurer shall comply with the
requirements governing provider and supplier requests for error
correction established under Section 401.717 of Title 42 of the Code
of Federal Regulations for all claims data received, including data
from sources other than Medicare.
   (b) For purposes of this section, the following definitions apply:
   (1) "Provider" means a hospital, a skilled nursing facility, a
comprehensive outpatient rehabilitation facility, a home health
agency, a hospice, a clinic, or a rehabilitation agency.
   (2) "Supplier" means a physician and surgeon or other health care
practitioner, or an entity that furnishes health care services other
than a provider.



Section: 57

Last modified: February 16, 2015