RI Gen L § 27-18.9-6(a)(1-2)

October 15, 2021 5:26 am | Published by

(1) For urgent or emergent healthcare services, benefit determinations (adverse or non-adverse) shall be made as soon as possible taking into account exigencies but not later than 72 hours after receipt of the claim.

(2) For concurrent claims (adverse or non-adverse), no later than twenty-four (24) hours after receipt of the claim and prior to the expiration of the period of time or number of treatments. The claim must have been made to the healthcare entity or review agent at least twenty-four (24) hours prior to the expiration of the period of time or number of treatments.

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