CA PPO Script – Interest Owed on Late Claims
August 30, 2020 10:29 pmASK YOURSELF: What date was the claim initially billed? What date was the claim paid? Did they pay this claim... View more
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CA PPO Script – Non-urgent Authorization Timeframes
August 30, 2020 10:25 pmASK YOURSELF: What date was the request for non-urgent authorization made? Was there any written communication (request for information, denial,... View more
CA PPO Affidavit – Patient Not Eligible
August 29, 2020 5:49 pmAFFIDAVIT OF COMPLIANCE Patient Not Eligible Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
CA PPO Affidavit – Untimely Payment
August 29, 2020 5:47 pmAFFIDAVIT OF COMPLIANCE Prompt Payment to Providers Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
CA PPO Affidavit – Retroactive Denial for Authorized Care
August 29, 2020 5:43 pmAFFIDAVIT OF COMPLIANCE Retroactive Denial of Authorized Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
CA PPO Affidavit – Refund Recoupment
August 29, 2020 5:40 pmAFFIDAVIT OF COMPLIANCE Recoupment Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: DOS:... View more
CA PPO Affidavit – Notice Requirements for Adverse Determinations
August 29, 2020 5:40 pmAFFIDAVIT OF COMPLIANCE Notice Requirements for Adverse Determinations Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
CA PPO Affidavit – No Authorization for ER Services and Care
August 29, 2020 5:35 pmAFFIDAVIT OF COMPLIANCE Emergency and Urgently Needed Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
CA PPO Affidavit – Medical Necessity – Qualified Reviewers
August 29, 2020 5:33 pmAFFIDAVIT OF COMPLIANCE Medical Necessity Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
CA PPO Affidavit – Maternity Coverage
August 29, 2020 5:29 pmAFFIDAVIT OF COMPLIANCE Maternity Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more