TX HMO Affidavit – Refund Recoupment
May 5, 2021 1:37 pmAFFIDAVIT OF COMPLIANCE Refund Recoupment Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
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TX HMO Affidavit – Poststabilization Timeframe
May 5, 2021 1:33 pmAFFIDAVIT OF COMPLIANCE Poststabilization Care Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
TX HMO Affidavit – Notice Requirements for Adverse Determinations
May 5, 2021 1:30 pmAFFIDAVIT OF COMPLIANCE Notice Requirements for Adverse Determinations Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
TX HMO Affidavit – No Authorization for ER Services and Care
May 5, 2021 1:26 pmAFFIDAVIT OF COMPLIANCE Emergency and Urgently Needed Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
TX HMO Affidavit – Medical Necessity – Qualified Reviewers
May 5, 2021 1:21 pmAFFIDAVIT OF COMPLIANCE Medical Necessity – Competent Reviewer Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
TX HMO Affidavit – Maternity Coverage
May 5, 2021 1:16 pmAFFIDAVIT OF COMPLIANCE Maternity Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
TX HMO Affidavit – Interest Owed on Late Claims
May 5, 2021 1:14 pmAFFIDAVIT OF COMPLIANCE Interest Owed on Late Claims Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
TX HMO Affidavit – Non-urgent Authorization Timeframes
May 5, 2021 1:12 pmAFFIDAVIT OF COMPLIANCE Timeframes for Authorization Requests – Non-Urgent Health Services Incorporated by Reference in 28 US Code § 1746... View more
NY HMO Script – Untimely Payment
May 5, 2021 1:53 amASK YOURSELF: What date was the claim initially billed? Was there any written communication (request for information, denial, underpayment) from... View more
NY HMO Script – Retroactive Denial for Authorized Care
May 5, 2021 1:51 amASK YOURSELF: Was the coverage terminated? Did we verify eligibility? IF SO, WHAT DATE? Did the plan make negligent misrepresentation... View more