Health and Safety Code §1371.8
August 28, 2020 5:11 pmA health care service plan that authorizes a specific type of treatment by a provider shall not rescind or modify... View more
A health care service plan that authorizes a specific type of treatment by a provider shall not rescind or modify... View more
(b) A health plan shall respond to a request delivered under section 10 of this chapter as follows: (1) If... View more
(3) If the request is for a nonurgent care situation, the health plan shall respond with a prior authorization determination... View more
(a) This section applies to a claim for a health care service rendered by a participating provider: (1) for which:... View more
(b) The health maintenance organization shall appoint a panel of qualified individuals to resolve an appeal. An individual may not... View more
(f) A health maintenance organization shall notify the enrollee or subscriber in writing of the resolution of the appeal of... View more
(c) As described in subsection (d), each health maintenance organization shall cover and reimburse expenses for care obtained in an... View more
(a) Except as provided in section 5 of this chapter, every policy or group contract that provides maternity benefits must... View more
(a) An insurer may not, more than two (2) years after the date on which an overpayment on a provider... View more
(a) An insurer shall pay or deny each clean claim as follows: (1) If the claim is filed electronically, within... View more