Illinois § 20

§ 20.

Uniform electronic claims and eligibility transactions required. (a) Beginning January 1, 2027, no dental plan carrier is required to accept from a dental care provider eligibility for a dental plan transaction or dental care claims or equivalent encounter information transaction except as provided in this Act. (b) All dental plan carriers and dental care providers must exchange claims and eligibility information electronically using the standard electronic data interchange transactions for claims submissions, payments, and verification of benefits required under the Health Insurance Portability and Accountability Act in order to be compensable by the dental plan carrier. (c) All dental plan carriers and dental care providers must comply with applicable State and federal privacy and security laws, and regulations when conducting the exchange of information under this Act. (Source: P.A. 103-705, eff. 7-19-24; 104-203, eff. 8-15-25.)