Health insurance claims; electronic attachments accepted, delayed effective date.
Health insurance; carrier business practices; electronic attachments. Provides that, in the following contexts, information may be submitted by a provider to a health insurance carrier through electronic attachment, as defined in the bill: (i) information related to services rendered as required by the carrier in its provider contract; (ii) information related to any defect or impropriety that prevents the carrier from deeming a health insurance claim a clean claim, as defined in existing law; and (iii) information required to establish medical necessity, benefit coverage, or prior authorization of services, or to conduct reconsideration activities. The bill has a delayed effective date of January 1, 2027.
← Back to Michelle Maldonado's profile