Ama Policy

Excessive Requests for Information from Insurance Carriers and Delays in Processing Insurance Claims H-190.991

Prompt Payment Deadlines

1. It is the policy of our AMA (A) to continue to oppose excessive and unnecessary requests for additional information and unexplained delays in processing and payment by third party insurance carriers where a completed standard claim form for reimbursement has been submitted, and (B) that state medical societies should pursue existing AMA model legislation to require the payment of claims with interest where clean claims are not paid on a timely basis.

2. Our AMA will: (A) work with all payers to ensure that they stop the practice of delaying payments by asking for documentation to review, prior to payment; and (B) work with payers to establish rules to continue to allow the payer to conduct prepayment documentation review if the payer has performed a post payment documentation review and proven that the provider has been submitting incorrect claims.

3. If efforts to work with payers to end the practice of delaying payments without reasonable justification fail, our AMA will seek legislation that would accomplish this.


Policy Timeline

Sub. Res. 69, A-91 Modified: Sunset Report, I-01 Reaffirmation I-04 Reaffirmation A-09 Appended: Res. 822, I-13