Search Results

Ama Policy

Third Party Responsibility for Payment H-185.981

03/13/2019
Retroactive Denial
Ama Policy

Prior Authorization Relief in Medicare Advantage Plans H-320.938

03/13/2019
Amendments, Retroactive Denial
Ama Policy

Preauthorization for Payment of Services H-320.961

03/14/2019
Retroactive Denial
ARC Advocacy Resources

Prior Authorization Model Bill

Addresses the burden of prior authorizations on patients and physicians by increasing the transparency in prior authorization requirements, ensuring that payers respond to requests in a timely manner and preventing retroactive denials of authorizations.

Medical Necessity-Definition, Model Legislation, Retroactive Denial, State Medical Necessity Decisions-Deadlines, U.R. Criteria
State Law

Code of Alabama 1975-Title 27-Chapter 1. General Provisions

06/11/2020 Alabama Section 27-1-17

Limitation periods for payment of claims; overdue claims; retroactive denials, adjustments, etc.; penalties.

Claims Filing Deadlines, Overpayments / Recoupments, Prompt Payment Deadlines, Retroactive Denial
State Law

Alaska Admin. Code-Title 21-Chapter 07. Patient Protections Under Health Care Insurance Policies

06/11/2020 Alaska Section 21.07.020

Required contract provisions for health care insurance policy

Retroactive Denial
State Law

Alaska Admin. Code-Title 3-Chapter 28-Article 10. Utilization Review and Benefit Determinations

06/11/2020 Alaska Section 28.910

Procedures for standard utilization review and benefit determinations

Retroactive Denial, State Medical Necessity Decisions-Deadlines