tci Medicare Compliance & Reimbursement - 2010 Issue 22

Billing: Know Your State's Prompt Pay Laws -- And Appeal When Necessary

Medicare requires contractors to pay your clean claims within 30 days, but private payers differ by state. You've submitted a claim that you know is clean, you've waited three months, and you still haven't collected. Do you have any recourse? Yes, thanks to the prompt pay laws that each state must follow when paying your medical claims.What are prompt pay laws: Each state requires private insurers to pay all clean claims within a certain time frame. If the insurer does not pay the claim in a timely manner, then the payer is subject to paying interest on the...

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