Time for recoupment

1. Law
2. Arkansas Code
3. Public Utilities and Regulated Industries
4. Insurance
5. Insurance Companies Generally
6. Audits of Medical Providers
7. Time for recoupment

1. (a)

   1. (1) Except in cases of fraud committed by a healthcare provider, a healthcare insurer may exercise recoupment from a healthcare provider only during the eighteen-month period after the date that the healthcare insurer paid the claim submitted by the healthcare provider.

   2. (2) A healthcare provider may submit a corrected claim for up to six (6) months after recoupment for services that were actually provided but billed in error without the intent to defraud.

2. (b)

   1. (1) A healthcare insurer that exercises recoupment under this section shall give the healthcare provider a written or electronic statement specifying the basis for the recoupment.

   2. (2) At a minimum, the statement shall contain the information required by § 23-63-1804.

Download our app to see the most-to-date content.