IN HMO Script – Medical Necessity – Qualified Reviewers
October 10, 2021 3:05 pmASK YOURSELF: Who denied the claim? What is the professional’s license number with the State Medical Board? Were they a... View more
Archives
IN HMO Script – Maternity Coverage
October 10, 2021 2:01 pmASK YOURSELF: Did we verify eligibility? IF SO, WHAT DATE? Did the plan make negligent misrepresentation of the patient’s eligibility?... View more
IN HMO Script – Interest Owed on Late Claims
October 10, 2021 1:30 pmASK YOURSELF: What date was the claim initially billed? What date was the claim paid? Did the plan pay this... View more
IN HMO Script – Non-urgent Authorization Timeframes
October 10, 2021 1:27 pmASK YOURSELF: What date was the request for non-urgent authorization made? Was there any written communication (request for information, denial,... View more
IN HMO Appeal – Untimely Payment
October 10, 2021 12:49 pmIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Indiana Department... View more
IN HMO Appeal – Retroactive Denial for Authorized Care
October 10, 2021 12:06 pmIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Indiana Department... View more
IN HMO Appeal – Refund Recoupment
October 10, 2021 11:35 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Indiana Department... View more
IN HMO Appeal – Poststabilization Timeframe
October 10, 2021 10:50 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Indiana Department... View more
IN HMO Appeal – Notice Requirements for Adverse Determinations
October 9, 2021 11:44 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Indiana Department... View more
IN HMO Appeal – No Authorization for ER Services and Care
October 9, 2021 11:20 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Indiana Department... View more