GA HMO Affidavit – Interest Owed on Late Claims
Last Updated: November 21, 2021 | Letter Type: Affidavits | Jurisdiction: GA HMO
AFFIDAVIT OF COMPLIANCE Interest Owed on Late Claims 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 Plan or Contracted Entity has met the provisions of GA Code §33-24-59.14(c), which states:... View more
GA HMO Affidavit – Maternity Coverage
Last Updated: October 15, 2021 | Letter Type: Affidavits | Jurisdiction: GA 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 Health Plan or Contracted Entity has met the provisions of GA Code §33-24-58.2(b-c), which states: (b) Every... View more
GA HMO Affidavit – No Authorization for ER Services and Care
Last Updated: November 20, 2021 | Letter Type: Affidavits | Jurisdiction: GA HMO
AFFIDAVIT OF COMPLIANCE Emergency and Urgently Needed 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 Plan or Contracted Entity has met the provisions of GA Code §33-21-18.1 which states:... View more
GA HMO Affidavit – Refund Recoupment
Last Updated: November 20, 2021 | Letter Type: Affidavits | Jurisdiction: GA HMO
AFFIDAVIT OF COMPLIANCE Refund Recoupment 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 Plan or Contracted Entity has met the provisions of GA Code §33-20A-62(a-b), which states: (a) No carrier,... View more
GA HMO Affidavit – Retroactive Denial for Authorized Care
Last Updated: November 20, 2021 | Letter Type: Affidavits | Jurisdiction: GA HMO
AFFIDAVIT OF COMPLIANCE Retroactive Denial of Authorized 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 Plan or Contracted Entity has met the provisions of GA Code §33-20A-7.1(b), which... View more
GA HMO Affidavit – Untimely Payment
Last Updated: October 15, 2021 | Letter Type: Affidavits | Jurisdiction: GA 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 Health Plan or Contracted Entity has met the provisions of GA Code §33-24-59.14(b)(1), which states: (b)(1) All... View more
GA HMO Appeal – Interest Owed on Late Claims
Last Updated: November 21, 2021 | Letter Type: Appeals | Jurisdiction: GA HMO
URGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the Georgia Division of Insurance for ‘s failure to remit automatic interest accrued on this claim as required by state law. Our investigation has concluded the following: Per GA Code §33-24-59.14(b)(1), was required to reimburse this claim... View more
GA HMO Appeal – Maternity Coverage
Last Updated: November 21, 2021 | Letter Type: Appeals | Jurisdiction: GA HMO
IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Georgia Division of Insurance for ’s failure to provide coverage for maternity services and care as required by state law. Our investigation has concluded the following: Under existing Georgia law, has a duty to provide all Maternity-covered... View more
GA HMO Appeal – No Authorization for ER Services and Care
Last Updated: November 20, 2021 | Letter Type: Appeals | Jurisdiction: GA HMO
IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Georgia Division of Insurance for ‘s failure to reimburse emergency services as required by state law. Our investigation has concluded the following: As the services rendered were emergent, was not required to obtain authorization per GA Code... View more
GA HMO Appeal – Refund Recoupment
Last Updated: November 20, 2021 | Letter Type: Appeals | Jurisdiction: GA HMO
IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Georgia Division of Insurance for ’s failure to properly reimburse medically necessary services as required by state law. Our investigation has concluded the following: Please be advised that must meet the written requirements set forth in GA... View more