Claim for Reimbursement Treated as Disputed Claim

Checkout our iOS App for a better way to browser and research.

Sec. 6. A claim for reimbursement for services shall be treated as a disputed claim under this chapter if:

(1) it is submitted within one hundred twenty (120) days after the date that services are rendered;

(2) it is denied by the managed care organization;

(3) the hospital submits a written notice of dispute for the claim to the managed care organization not more than sixty (60) days after the receipt of the denial notice;

(4) it is appealed in accordance with the managed care organization's internal appeals process; and

(5) payment for the claim is denied by the managed care organization following its internal appeals process.

As added by P.L.142-2000, SEC.2. Amended by P.L.152-2017, SEC.9.


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