NJ Admin Code § 11:24-8.3(c)(1)(i)

October 15, 2021 5:17 am | Published by

(c) All determinations shall be made on a timely basis, as required by the exigencies of the situation.

(1) An HMO shall notify a provider and/or member of a determination concerning:

(i) An urgent care claim and determination by the attending provider as soon as possible, taking into account the medical exigencies, but no later than 72 hours after receipt of the urgent care claim by the HMO

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