(a) Each facility in operation for all or any of the
reporting periods described in §421.73 of this title (relating
to Schedule for Filing Event Files) shall submit to DSHS emergency
visit claims as specified in §421.77 of this title (relating
to Event Files--Records, Data Fields and Codes) on all emergency visit
patients. All facilities that are exempt under Texas Health and Safety
Code, Chapter 108, which choose to participate in reporting under
this subchapter, shall comply with the requirements in this subchapter.
To the extent the medical screening examination, triage, observation,
diagnosis or treatment is made by a health professional other than
a physician, data elements specified in §421.77(d)(25) - (30)
of this title shall be filed accordingly or data elements in §421.77(d)(26)
or (29) of this title in the modified ANSI 837 Institutional Guide
shall be marked with one of DSHS approved temporary "Physician" or
"Other health professional" code numbers and data elements in §421.77(d)(28)(A)
- (C) of this title in the ANSI 837 Institutional Guide format may
be left blank.
(b) All emergency visit events shall be reported by
the facility that prepares one or more bills for patient services.
The facility shall submit an event claim corresponding to each bill
containing the data elements required by §421.77 of this title.
For all patients who received one or more emergency services for which
the facility does not prepare a bill for patient services, the facility
shall submit an event claim containing the required minimum data set.
(c) Each facility shall submit event files by electronic
filing unless the facility receives an exemption letter from DSHS.
(d) Each facility shall submit event claims and event
files in the format specified in §421.77 of this title.
(e) Each facility shall submit event files, data certifications
and other required information to DSHS or its agents at physical,
universal resource locator (URL) addresses or telephonic addresses
specified by DSHS. DSHS shall notify all facilities and submitters
in writing and by publication in the Texas Register at least 30 calendar
days before any change in the addresses.
(f) Each facility may submit event files, or may designate
an agent to submit the event files. If a facility designates an agent,
it shall inform DSHS of the designation in writing at least 30 calendar
days prior to the agent's submission of any discharge report. The
facility shall inform DSHS in writing at least 30 calendar days prior
to changing agents or making the submissions itself.
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