NE HMO Script – Interest Owed on Late Claims
September 10, 2025 8:42 pmASK YOURSELF: What date was the claim initially billed? What date was the claim paid? Did the plan pay this... View more
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NE HMO Script – Non-urgent Authorization Timeframes
September 10, 2025 8:38 pmASK YOURSELF: What date was the request for non-urgent authorization made? Was there any written communication (request for information, denial,... View more
NE HMO Affidavit – Untimely Payment
September 10, 2025 8:16 pmAFFIDAVIT OF COMPLIANCE Prompt Payment to Providers Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – Retroactive Denial for Authorized Care
September 10, 2025 8:13 pmAFFIDAVIT OF COMPLIANCE Retroactive Denial of Authorized Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – Refund Recoupment
September 10, 2025 8:10 pmAFFIDAVIT OF COMPLIANCE Refund Recoupment Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – Poststabilization Timeframe
September 10, 2025 8:06 pmAFFIDAVIT OF COMPLIANCE Poststabilization Care Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – Notice Requirements for Adverse Determinations
September 10, 2025 7:15 pmAFFIDAVIT OF COMPLIANCE Notice Requirements for Adverse Determinations Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – No Authorization for ER Services and Care
September 10, 2025 7:12 pmAFFIDAVIT OF COMPLIANCE Emergency and Urgently Needed Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – Medical Necessity – Qualified Reviewers
September 10, 2025 6:45 pmAFFIDAVIT OF COMPLIANCE Medical Necessity – Competent Reviewer Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
NE HMO Affidavit – Maternity Coverage
September 10, 2025 6:41 pmAFFIDAVIT OF COMPLIANCE Maternity Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more