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1 Managed Care Law; Prompt Payment Required; Notice Requirement. Amend RSA 420-J:8-a, I(b) to read as follows:
(b) When the health carrier is denying or pending the claim, the carrier shall have 15 calendar days upon receipt of an electronic claim or 30 days upon receipt of a non-electronic claim to notify the health care provider or covered person of the reason for denying or pending the claim and what, if any, additional information is required to adjudicate the claim. Upon the health carrier's receipt of the requested additional information, the health carrier shall adjudicate the claim within 45 calendar days. If the required notice is not provided , the claim shall be treated as a clean claim and shall be adjudicated pursuant to subparagraph (a)
2 Effective Date. This act shall take effect 60 days after its passage.
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1 Managed Care Law; Prompt Payment Required; Notice Requirement. Amend RSA 420-J:8-a, I(b) to read as follows:
(b) When the health carrier is denying or pending the claim, the carrier shall have 15 calendar days upon receipt of an electronic claim or 30 days upon receipt of a non-electronic claim to notify the health care provider or covered person of the reason for denying or pending the claim and what, if any, additional information is required to adjudicate the claim. Upon the health carrier's receipt of the requested additional information, the health carrier shall adjudicate the claim within 45 calendar days. If the health carrier either fails to provide required notice or to adjudicate the claim within 45 calendar days of receipt of additional information , the claim shall be treated as a clean claim and shall be adjudicated pursuant to subparagraph (a)
2 Effective Date. This act shall take effect 60 days after its passage.