Ama Policy

Insurance Coverage Appeals D-320.993

Prompt Payment Deadlines

Our AMA will:

(1) continue to support the development of more stringent state laws and regulations that provide compensation to physicians for the administrative burden and costs of the health plan documentation requirements, such as the appeal process;

(2) continue to advocate to ensure that physicians receive prompt, fair payment from health plans through educational products, seminars and advocacy efforts;

(3) continue to encourage health plans to implement online appeal processes to reduce the administrative burden and cost to physicians and their patients when claims are denied inappropriately;

(4) continue to encourage health plans to streamline, provide transparency, and lessen the administrative burdens and costs that are incurred by physicians through the health plans appeals processes;

(5) remain an active participant in the standards development activities of several standards development organizations and data content committees; and

(6) continue in its leadership role in the National Uniform Claims Committee and its work with the standards development organizations.


Policy Timeline

BOT Rep. 23, A-06 Modified: CMS Rep. 01, A-16 Reaffirmation: I-17