South Dakota § 58-17-149 Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period.

South Dakota Statutes

§ 58-17-149 — Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period.

South Dakota § 58-17-149

Title 58INSURANCE

Ch. 58-13HEALTH INSURANCE POLICIES

This text of South Dakota § 58-17-149 (Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period.) is published on Counsel Stack Legal Research, covering South Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

S.D. Codified Laws § 58-17-149 (2026).

Text

Terms used in §§ to 58-17-152 , inclusive, mean:

(1)"Application date," the date on which a health insurer or other entity responsible for the credentialing of health care professionals on behalf of the health insurer receives the health care professional's completed application for credentialing or change request;

(2)"Clean claim," as defined in § 58-12-19 ;

(3)"Health care professional," as defined in subdivision 58-17F-1(8);

(4)"Health insurer," as defined in subdivision 58-17-100(2);

(5)"Special Review," a supplemental review of a health care professional's completed application for credentialing or change request by a health insurer or other entity responsible for credentialing of health care professionals necessitated by credible evidence received by a health insu

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Terms used in §§ to 58-17-152 , inclusive, mean: (1) "Application date," the date on which a health insurer or other entity responsible for the credentialing of health care professionals on behalf of the health insurer receives the health care professional's completed application for credentialing or change request; (2) "Clean claim," as defined in § 58-12-19 ; (3) "Health care professional," as defined in subdivision 58-17F-1(8); (4) "Health insurer," as defined in subdivision 58-17-100(2); (5) "Special Review," a supplemental review of a health care professional's completed application for credentialing or change request by a health insurer or other entity responsible for credentialing of health care professionals necessitated by credible evidence received by a health insurer or other entity responsible for credentialing of health care professionals as it relates to investigation of the following: action taken against the applicant's licensure status, action taken against the applicant's professional society status, verified complaints to facilities, or licensing agency regarding the applicant; the applicant's non-completion of training programs; a criminal proceeding brought against the applicant a malpractice claim brought against the applicant; loss of a Drug Enforcement Administration certificate or state-controlled substance certificate; loss of a Medicare or Medicaid certification status; or involuntary termination of credentialing by a different health insurer.