Claims and Utilization Review

  1. Law
  2. Maryland Code
  3. Insurance
  4. Health Insurance
  5. Claims and Utilization Review

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Section
15-1001

Requirement for utilization review

Section
15-1002

Claim forms to conform to regulations

Section
15-1003

Adoption of uniform claims forms required

Section
15-1004

Acceptance of uniform claims forms required

Section
15-1005

Prompt payment of claims

Section
15-1006

Notice of reason for denial of claim

Section
15-1007

Summary explanation of benefits

Section
15-1008

Retroactive denial of reimbursement

Section
15-1009

"Carrier" defined; reimbursement for preauthorized care; payment of claims

Section
15-1010

"Disability benefit" and "adverse benefit determination" defined; regulations

Section
15-1011

Expense reimbursement claims forms -- Methods for submission.