28 Pa. Code §9.705(c)(1)(vi)
October 15, 2021 5:43 am(vi) The plan shall notify the enrollee in writing of the decision of the initial review committee within 5 business... View more
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GA Code §33-20A-62(a-b)
October 15, 2021 5:42 am(a) No carrier, plan, network, panel, or any agent thereof may conduct a postpayment audit or impose a retroactive denial... View more
NV Rev Stat §689A.717(1-3)
October 15, 2021 5:42 am(1) Except as otherwise provided in this subsection, an individual health benefit plan issued pursuant to this chapter that includes... View more
Ohio Rev Code §3923.65(B)
October 15, 2021 5:39 am(B) Every individual or group policy of sickness and accident insurance that provides hospital, surgical, or medical expense coverage shall... View more
Ohio Rev Code §3901.388(A,C)
October 15, 2021 5:36 am(A) A payment made by a third-party payer to a provider in accordance with sections 3901.381 to 3901.386 of the... View more
Ohio Rev Code §3923.041(B)(4)(a)
October 15, 2021 5:36 am(a) For policies issued on or after January 1, 2018, if the health care practitioner submits the request for prior... View more
Ohio Rev Code §3901.381(B)(1)
October 15, 2021 5:36 am(B)(1) Unless division (B)(2) or (3) of this section applies, when a third-party payer receives from a provider or beneficiary... View more
RI Gen L § 27-18.9-6(a)(3)
October 15, 2021 5:35 am(3) For pre-service claims (adverse or non-adverse), within a reasonable period of time appropriate to the medical circumstances, but not... View more
RI Gen L § 27-41-30.1(a)
October 15, 2021 5:34 am(a) Every individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state... View more
RI Gen L § 27-41-64(d)
October 15, 2021 5:34 am(d) A health care entity or health plan which fails to reimburse the health care provider or policyholder after receipt... View more