R380-25. Submission of Data Through an Electronic Data Interchange  


R380-25-1. Purpose and Authority
Latest version.

This rule provides for the submission of information to the Department of Health through an electronic data interchange (EDI). Subsections 26-1-30(2)(d), 26-1-30(2)(e), 26-1-30(2)(f), 26-1-30(2)(g), 26-1-30(2)(p), and 26-1-30(2)(w); Sections 26-3-5; and 26-3-6 authorize this rule.


R380-25-2. Definitions
Latest version.

These definitions apply to the rule:

(1) "Health data" as defined in Subsection 26-3-1(2).

(2) "Electronic data interchange" means an entity that receives billing, claim, or other electronically transmissible information from a data supplier and transmits it to another party.

(3) "Data supplier" as defined in Section 26-33a-102(3).


R380-25-3. Confidentiality
Latest version.

(1) Health data received by the Department of Health is confidential and protected as provided in Title 26, Chapter 3.

(2) The Department of Health shall not store or use any information it receives from an EDI that the Department is not authorized to collect by statute, rule or agreement with a data supplier.

(3) An EDI that receives and forwards health data or other information to the Department of Health on behalf of a data supplier without inspecting the contents of the information does not violate patient confidentiality or individual privacy rights.


R380-25-4. Required Forwarding
Latest version.

An EDI that is instructed by a data supplier to forward information to the Department of Health must do so as instructed.