CA HMO Affidavit – Maternity Coverage (FREE DEMO)
Last Updated: November 21, 2021 | Letter Type: Affidavits | Jurisdiction: CA HMO
AFFIDAVIT OF COMPLIANCE Maternity Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: DOS: I hereby certify that I have collected, verified, and am maintaining on file evidence that the below Knox-Keene Licensed Plan or Contracted Entity has met the provisions of Health and Safety Code §1367.62(a) which... View more
CA HMO Affidavit – Untimely Payment (FREE DEMO)
Last Updated: August 29, 2020 | Letter Type: Affidavits | Jurisdiction: CA HMO
AFFIDAVIT OF COMPLIANCE Prompt Payment to Providers Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: DOS: I hereby certify that I have collected, verified, and am maintaining on file evidence that the below Knox-Keene Plan or Contracted Entity has met the provisions of 28 CCR §1300.71(g), which states:... View more
CA HMO Appeal – Maternity Coverage (FREE DEMO)
Last Updated: November 21, 2021 | Letter Type: Appeals | Jurisdiction: CA HMO
IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Department of Managed Health Care (DMHC) for ’s failure to provide coverage for maternity services and care as required by state law. Our investigation has concluded the following: As you may know, Health and Safety Code §1317.1(a)(1)... View more
CA HMO Appeal – Untimely Payment (FREE DEMO)
Last Updated: November 20, 2021 | Letter Type: Appeals | Jurisdiction: CA HMO
URGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the Department of Managed Health Care (DMHC) for ’s failure to timely reimburse this claim as required by State law. Prompt reimbursement of a claim is defined under 28 CCR §1300.71(g): A plan or a plan’s capitated... View more
CA PPO Affidavit – Maternity Coverage (FREE DEMO)
Last Updated: November 21, 2021 | Letter Type: Affidavits | Jurisdiction: CA PPO
AFFIDAVIT OF COMPLIANCE Maternity Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: DOS: I hereby certify that I have collected, verified, and am maintaining on file evidence that the below Health Insurer or Contracted Entity has met the provisions of Cal. Ins. Code §10123.87(a) which states, in... View more
CA PPO Affidavit – Untimely Payment (FREE DEMO)
Last Updated: August 29, 2020 | Letter Type: Affidavits | Jurisdiction: CA PPO
AFFIDAVIT OF COMPLIANCE Prompt Payment to Providers Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: DOS: I hereby certify that I have collected, verified, and am maintaining on file evidence that the below Health Insurer or Contracted Entity has met the provisions of Cal. Ins. Code §10123.13(a) and... View more
CA PPO Appeal – Maternity Coverage (FREE DEMO)
Last Updated: August 29, 2020 | Letter Type: Appeals | Jurisdiction: CA PPO
IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the California Department of Insurance (CDI) for ’s failure to reimburse medically necessary maternity services as required by state law. Our investigation has concluded the following: Under existing state law, has a duty to provide all Maternity-covered services... View more
CA PPO Appeal – Untimely Payment (FREE DEMO)
Last Updated: November 20, 2021 | Letter Type: Appeals | Jurisdiction: CA PPO
URGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the California Department of Insurance (CDI) for ’s failure to timely reimburse medically necessary services as required by state law. As you are aware, is required to issue written notice if a claim or a portion is... View more
ERISA Affidavit – Untimely Payment (FREE DEMO)
Last Updated: July 6, 2022 | Letter Type: Affidavits | Jurisdiction: ERISA
AFFIDAVIT OF COMPLIANCE Payment to Providers Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: DOS: I hereby certify that I have collected, verified, and am maintaining on file evidence that the below Employer/Third-Party Administrator or Contracted Entity has met the provisions of 29 CFR §2560.503-1(f)(2)(iii)(B), which states:... View more
ERISA Appeal – Untimely Payment (FREE DEMO)
Last Updated: November 20, 2021 | Letter Type: Appeals | Jurisdiction: ERISA
IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Centers for Medicare and Medicaid Services (CMS) for ’s failure to reimburse health services as required by Federal law. Our investigation has concluded the following: As you know, federal law requires to pay this claim within 30... View more