CO Rev. Stat §10-16-106.5(5)(b)
August 8, 2021 8:29 amA carrier that fails to pay, deny, or settle a claim in accordance with subsection (4) of this section within... View more
Archives
CO Rev. Stat. §10-16-113(3)(b)(IV)(A)
August 8, 2021 8:20 am(IV)(A) The second-level internal review of an appeal from the denial of a request for covered benefits pursuant to subparagraph... View more
CO Rev. Stat. §10-16-113(3)(b)(III)(A)
August 8, 2021 8:20 am(III)(A) A physician shall evaluate the first-level appeal and shall consult with an appropriate clinical peer or peers, unless the... View more
CO Rev. Stat. §10-16-113(2-3)
August 8, 2021 3:41 am(2) Following a denial of a request for benefits or an adverse determination by the carrier, the carrier shall notify the... View more
37 Fla. Stat. §641.51(4)
August 8, 2021 3:40 am(4) The organization shall ensure that only a physician holding an active, unencumbered license issued under chapter 458 or chapter... View more
NY Ins L §4904(c-d)
August 8, 2021 3:38 am(c) A utilization review agent shall establish a standard appeal process which includes procedures for appeals to be filed in writing... View more
6 TIC §843.259(a-b)
August 8, 2021 3:37 am(a) A health maintenance organization shall include in a notice of the final decision on an appeal a statement of... View more
6 TIC §843.253(b)
August 8, 2021 3:36 am(b) After a health maintenance organization has investigated a complaint, the health maintenance organization shall issue a response letter to... View more
CO Rev. Stat. §10-16-704(4.5)(b-c)
August 8, 2021 3:19 am(b) Except as otherwise provided in this subsection (4.5), adjustments to claims by the provider or the carrier shall be made... View more
CO Rev. Stat. §10-16-704(4.5)(L)(I)
August 8, 2021 3:18 am(L)(I) Any adjustment made by the carrier that recovers carrier overpayments to a provider shall include a written notice to... View more