28 CCR §1300.71(b)(4)

August 28, 2020 5:29 pm | Published by

(4) A plan or a plan’s capitated provider that denies a claim because it was filed beyond the claim filing deadline, shall, upon provider’s submission of a provider dispute pursuant to section 1300.71.38 and the demonstration of good cause for the delay, accept, and adjudicate the claim according to Health and Safety Code section 1371 or 1371.35, whichever is applicable, and these regulations.

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