MO HMO Script – Retroactive Denial for Authorized Care
October 15, 2021 7:23 amASK YOURSELF: Was the coverage terminated? Did we verify eligibility? If so, what date and time? Did the plan make... View more
Archives
MO HMO Script – Untimely Payment
October 15, 2021 7:20 amASK YOURSELF: What date was the claim initially billed? Was there any written communication (request for information, denial, underpayment) from... View more
MO HMO Script – Poststabilization Timeframe
October 15, 2021 7:16 amASK YOURSELF: When was the patient stabilized in the emergency room or admitted as an inpatient? Was the admission during... View more
MCL §500.2006(3)
October 15, 2021 7:05 am(a) A clean claim must be paid within 45 days after receipt of the claim by the health plan. A... View more
MCL §500.2213(j)
October 15, 2021 7:05 am(j) That when an adverse determination is made, a written statement containing the reasons for the adverse determination is provided... View more
MCL §500.2006(4)(a)
October 15, 2021 7:04 am(a) A clean claim must be paid within 45 days after receipt of the claim by the health plan. A... View more
KS Stat §40-2442(a)
October 15, 2021 7:03 am(a) Within 30 days after receipt of any claim, and amendments thereto, any insurer issuing a policy of accident and... View more
KS Stat §40-22a09a(f)(1)
October 15, 2021 6:53 am(f) The health insurance plan or utilization review organization shall provide the insured a written decision setting forth the relevant... View more
KS Stat §40-2442(f)
October 15, 2021 6:50 am(f) In the event that an insurer erroneously pays a claim providing benefits to which the insured person or provider... View more
KS Stat §40-3228(c)(3)
October 15, 2021 6:32 am(c) that upon receiving notification of a grievance related for payment of a bill for medical services, the health maintenance... View more