Procedure for Presentation of Claims and Payment of Benefits

1. Law
2. Georgia Code
3. Public Officers and Employees
4. Employees' Insurance and Benefits Plans
5. State Employees' Health Insurance Plan and Post-Employment Health Benefit Fund
6. State Employees' Health Insurance Plan
7. Procedure for Presentation of Claims and Payment of Benefits

1. Any benefits payable under the plan may be made either directly to the attending physicians, hospitals, medical groups, or others furnishing the services upon which a claim is based or to the covered employee, upon presentation of valid bills for such services, subject to such provisions to facilitate payment as may be made by the board.
2. The claims must be presented in writing to the board or its designee within two years from the date the service was rendered or else no benefits will be owed or paid.
3. All drafts or checks issued by the board or the board's designee shall be void if not presented and accepted by the drawer's bank within six months of the date the draft or check was drawn. If the payee or member does not present the draft or check for acceptance during the seven years following the date the draft or check was issued, the draft or check will be void, funds will be retained in the insurance fund, and further payments for such claim will not be owed or paid.

(Ga. L. 1961, p. 147, § 9; Ga. L. 1979, p. 667, § 2; Ga. L. 1988, p. 397, § 1.)

Law reviews.

- For article surveying recent legislative and judicial developments regarding Georgia's insurance laws, see 31 Mercer L. Rev. 117 (1979).

RESEARCH REFERENCES

ALR.

- Criminal prosecution or disciplinary action against medical practitioner for fraud in connection with claims under medicaid, medicare, or similar welfare program for providing medical service, 50 A.L.R.3d 549.

Filing of false insurance claims for medical services as ground for disciplinary action against dentist, physician, or other medical practitioner, 70 A.L.R.4th 132.

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