IN HMO Affidavit – Interest Owed on Late Claims
October 8, 2021 8:41 amAFFIDAVIT OF COMPLIANCE Interest Owed on Late Claims Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
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IN HMO Affidavit – Non-urgent Authorization Timeframes
October 8, 2021 8:34 amAFFIDAVIT OF COMPLIANCE Timeframes for Authorization Requests – Non-Urgent Health Services Incorporated by Reference in 28 US Code § 1746... View more
AL HMO Script – Untimely Payment
October 7, 2021 7:04 pmASK YOURSELF: What date was the claim initially billed? Was there any written communication (request for information, denial, underpayment) from... View more
AL HMO Script – Refund Recoupment
October 7, 2021 6:48 pmASK YOURSELF: How many days after payment, did the HMO plan request the refund? Why did the plan request the... View more
NJ HMO Script – Poststabilization Timeframe
October 7, 2021 6:23 pmASK YOURSELF: When was the patient stabilized in the emergency room or admitted as an inpatient? Was the admission during... View more
RI HMO Script – Poststabilization Timeframe
October 7, 2021 6:22 pmASK YOURSELF: When was the patient stabilized in the emergency room or admitted as an inpatient? Was the admission during... View more
PA HMO Script – Poststabilization Timeframe
October 7, 2021 6:21 pmASK YOURSELF: When was the patient stabilized in the emergency room or admitted as an inpatient? Was the admission during... View more
AL HMO Script – Poststabilization Timeframe
October 7, 2021 6:17 pmASK YOURSELF: When was the patient stabilized in the emergency room or admitted as an inpatient? Was the admission during... View more
AL HMO Script – Notice Requirements for Adverse Determinations
October 7, 2021 6:15 pmASK YOURSELF: Who denied the claim? What is the professional’s license number with the State Medical Board? Were they a... View more
AL HMO Script – Medical Necessity – Qualified Reviewers
October 7, 2021 5:42 pmASK YOURSELF: Who denied the claim? What is the professional’s license number with the State Medical Board? Were they a... View more