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Found 435 Letters.

MO HMO Appeal – Untimely Payment

Last Updated: November 20, 2021 | Letter Type: Appeals | Jurisdiction: MO HMO

URGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the Missouri Department of Insurance for ’s failure to remit timely payment and automatic interest accrued on this claim as required by state law. Our investigation has concluded the following: Per Mo. Rev. Stat. §376.383(6),  was required... View more

NE HMO Affidavit – Interest Owed on Late Claims

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE 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 Neb. Rev. St. § 44-8005,... View more

NE HMO Affidavit – Maternity Coverage

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE 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 The Newborns’ and Mothers’... View more

NE HMO Affidavit – Medical Necessity – Qualified Reviewers

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE HMO

AFFIDAVIT OF COMPLIANCE Medical Necessity – Competent Reviewer 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... View more

NE HMO Affidavit – No Authorization for ER Services and Care

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE 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 Neb.... View more

NE HMO Affidavit – Non-urgent Authorization Timeframes

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE HMO

AFFIDAVIT OF COMPLIANCE Timeframes for Authorization Requests – Non-Urgent Health 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... View more

NE HMO Affidavit – Notice Requirements for Adverse Determinations

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE HMO

AFFIDAVIT OF COMPLIANCE Notice Requirements for Adverse Determinations 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 Neb.... View more

NE HMO Affidavit – Poststabilization Timeframe

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE HMO

AFFIDAVIT OF COMPLIANCE Poststabilization Care 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 Neb. Rev. St §... View more

NE HMO Affidavit – Refund Recoupment

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE 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 210 Neb. Admin.... View more

NE HMO Affidavit – Retroactive Denial for Authorized Care

Last Updated: September 10, 2025 | Letter Type: Affidavits | Jurisdiction: NE 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 The Ensuring Transparency in Prior Authorization Act... View more