karen1027 Posted August 20, 2014 Posted August 20, 2014 Does prompt payment apply to self-insured health plans?
Flyboyjohn Posted August 20, 2014 Posted August 20, 2014 Can you expand on what you're referring to as the "prompt payment" requirement?
karen1027 Posted August 21, 2014 Author Posted August 21, 2014 Claims submitted electronically msut be paid within 30 days of receipt. If submitted in another way (mail, etc) they must be paid within 40 days.
masteff Posted August 21, 2014 Posted August 21, 2014 Unless you have anything to show otherwise, it appears to me that "prompt pay" laws are at the state level. You will need to review applicable state law as well as federal district court cases such as discussed in this article: http://www.healthcarepayernews.com/content/ama-erisa-doesnt-preempt-state-payment-regulation#.U_ZOgE90zcs GBurns 1 Kurt Vonnegut: 'To be is to do'-Socrates 'To do is to be'-Jean-Paul Sartre 'Do be do be do'-Frank Sinatra
GBurns Posted August 23, 2014 Posted August 23, 2014 Prompt payment laws are state insurance laws which would not usually apply to self funded plans, but there are a few states that do regulate some aspects self funded plans. I suggest that you both check your state law and also seek legal counsel. George D. Burns Cost Reduction Strategies Burns and Associates, Inc www.costreductionstrategies.com(under construction) www.employeebenefitsstrategies.com(under construction)
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