NE HMO Appeal – Interest Owed on Late Claims
September 8, 2025 7:34 pmURGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the Nebraska... View more
Archives
Nebraska Department of Insurance
September 8, 2025 7:30 pmNE HMO Appeal – Non-urgent Authorization Timeframes
September 8, 2025 7:24 pmIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Nebraska Department... View more
CA HMO Appeal – Transportation Broker Failure No Authorization Denial
February 12, 2025 11:40 amURGENT- IMPERATIVE ACTION Dear Director of : Our office is considering filing a formal complaint with the Department of Managed... View more
WAC 284-170-431
January 22, 2025 12:58 am(2)(a) For health services provided to covered persons, a carrier shall pay providers and facilities as soon as practical but... View more
RCW 48.43.093 (d)
January 22, 2025 12:56 am(d) If a health carrier requires preauthorization for post evaluation or post stabilization services, the health carrier shall provide access... View more
RCW 48.43.093 (1)(b)
January 22, 2025 12:54 am(b) If an authorized representative of a health carrier authorizes coverage of emergency services, the health carrier shall not subsequently... View more
RCW 48.43.525 (1)
January 22, 2025 12:54 am(1) A health carrier that offers a health plan shall not retrospectively deny coverage for emergency and nonemergency care that... View more
RCW 48.43.600 (1-3)
January 22, 2025 12:51 am(1) Except in the case of fraud, or as provided in subsections (2) and (3) of this section, a carrier... View more
WAC 284-43-3070 (1-2, 4-8)
January 22, 2025 12:48 am(1) A carrier must notify enrollees of an adverse benefit determination either electronically or by U.S. mail. The notification must... View more