Ama Policy

Physician Reimbursement by Health Insurance and Managed Care Companies H-190.959

Prompt Payment Deadlines

1. Our AMA shall make it a top priority to seek regulatory and legislative relief to ensure that all health insurance and managed care companies pay for clean claims submitted electronically within fourteen days.

2. When electronic claims are deemed to be lacking information to make the claim complete, the health insurance and managed care companies will be required to notify the health care provider within five business days to allow prompt resubmission of a clean claim.

3. Our AMA shall advocate for heavy penalties to be imposed on health insurance and managed care companies, including their employees, that do not comply with laws and regulations establishing guidelines for claims payment.

4. Our AMA will continue to encourage regulators to enforce existing prompt pay requirements.


Policy Timeline

Sub. Res. 713, A-02 Modified: Res. 714, A-03 Reaffirmation I-04 Reaffirmed: CMS Rep. 1, A-14 Reaffirmed: Res 132, A-14 Reaffirmed: Sub. Res. 715, A-15 Appended: Res. 805, I-18