Know Your Rights: Making the most out of your appeals Thanks to California Medical Association (CMA)-sponsored legislation (AB 1455) signed into law in 2000 and the resulting regulations, payors are required to have a fast, fair and cost-effective dispute resolution mechanism (i.e., “appeal process”) to resolve provider disputes. Anytime a payor contests, adjusts or denies a claim, they are required to advise the provider of the availability of the appeal process and instructions for submitting the appeal. Payors are also required to acknowledge receipt of a written appeal within two working days for electronic appeals or 15 working days for ... September 13, 2016 CMA, General Know Your Rights, Appeals 0 0 Comment Read More »
Did you know: The key word in any appeal is... Thanks to California Medical Association (CMA) sponsored legislation (AB 1455) and the resulting regulations, payors are required to establish a fast, fair and cost-effective dispute resolution mechanism (i.e., “appeal process”) to resolve provider disputes. Anytime a payor contests, adjusts or denies a claim, they are required to advise the provider of the availability of the appeal process and instructions for submitting the appeal. Payors are also required to acknowledge receipt of a written appeal within two working days for electronic appeals or 15 working days for paper appeals. The payor ... August 6, 2015 General State Legislative Advocacy, Appeals 0 0 Comment Read More »
