28 CCR §1300.71(d)(6)

August 28, 2020 5:49 pm | Published by

A plan or a plan’s capitated provider may only offset an uncontested notice of reimbursement of the overpayment of a claim against a provider’s current claim submission when: (i) the provider fails to reimburse the plan or the plan’s capitated provider within the timeframe of section (5) above and (ii) the provider has entered into a written contract specifically authorizing the plan or the plan’s capitated provider to offset an uncontested notice of overpayment of a claim from the contracted provider’s current claim submissions.

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