Accounts Receivable Follow Up Form - CommPartners

Accounts Receivable Follow Up Form

Today’s Doctor: Patient Name: Account Balance:
Date: Patient:
Insurance:
Date of Service: Date Claim Filed: Date of Last Activity:

Primary Insurance: Secondary Insurance: I Spoke With....

Phone: Phone: His/Her Position:

Fax: Fax:

Was Claim Did Payor If Claim Unpaid, Codes and Descriptors of Unpaid Services:
Received? Pay Claim? 1. ___________________________________________
2. ___________________________________________
Yes Yes 3. ___________________________________________
4. ___________________________________________
No No

Check #
__________

Why Was Claim Not Paid? Action Taken (Be specific.)
(Denial Reason.)

When Can We Expect Payment? _______________

APPEAL
LETTERS

© The Sage Associates, 1997 reimb./apealtr

APPEAL LETTERS
Brief, To The Point, Clear

1. Restate all identification numbers from EOB

2. Get to the point in the first sentence:
“This is to appeal the amount allowed for (date of service.”

3. Make it easy to read and understand
• bullets or numbered paragraphs
• boldface type to focus attention
• layman’s terms
• keep to one page if possible

4. Be Nice
• Thank them for their help
• Keep a sense of humor
• Accept the responsibility for confusing them

5. Only discuss their basis for the denial, underpayment or cutback. Stay away from other
issues like:
• “We’re board certified”
• “This is the fourth time this patient has had this procedure”
• “You’ve been mistreating us since 1980”

6. Copy the patient

7. Follow Up

© The Sage Associates, 1997 reimb./apealtr

Enforce Contract Rates

ABC Medical Practice
123 Hometown Road
Your Town, CA 90000

Healthcare Insurance Company
Claims Review Section
P.O. Box 1111
Moneyplace, CA 90000

Re: Edna Jones

SSN: 123-45-1234

Claim: 231ER 45678HCI

Employer Name: Your Phone Company

Dear Claims Supervisor:

This is to appeal the amount allowed for surgery on 12/17/9x.

Our current contract with you ( dated 4/1/9x) calls for $50 per RBRVS unit according to the
HCFA schedule dated 12/1/95.

1. The claim was paid at $38.60 per unit
2. The services rendered total 25.7 units
3. The correct reimbursement is $1,285.
4. Additional due $382.66

Code Contracted You Balance

Billed RVUs Amount Paid Due

11111 12.7 $635.00 $494.09 $140.91
22222 16.0 @50% $400.00 $311.20 $ 89.00
33333 10.0 @ 50% $250.00 $ 97.25 $152.75
Totals $902.54 $382.66
$1,285.00

Sincerely,

Susie Sharp
Office Manager

© The Sage Associates, 1997 reimb./apealtr

Non-timely Payment of Claim

Attached is a copy of your claim for service for your insured. As of this date, we have not

received payment for days since we submitted the claim to you. We

have not received any notice that the claim was not complete or any indication that the

service was not properly authorized. Therefore, you appear to be in violation of California

Health & Safety Code Sec. 1371 (see language below). We expect full payment due for

these services to be remitted to us at once, along with the applicable interest due under the

statute. Continuing violation of this statute will be reported to the California Department of

Insurance or Department of Corporations as applies to your plan.

HSC Sec. 1371 A health care service plan...shall reimburse claims or any portion of a
claim, whether in state or out of state, as soon as practical, but no later than 30 working days
after receipt of the claim by the health care service plan, or, if the health care service plan is a
health maintenance organization, 45 working days after the receipt of the claim....If an
uncontested claim is not reimbursed within the respective 30 to 45 working days after receipt,
interest shall accrue at the rate of 10 percent per annum beginning with the first calendar day
after the 30 or 45 working day period.

© The Sage Associates, 1997 reimb./apealtr

Non-timely Payment of Claim After Further Information Sent:

Attached is a copy of our claim for services for your insured. As of this date, we have not

received payment for days since we submitted to you the additional information you

requested about this claim. We have not received any notice that the claim was being further

contested or questioned or any indication that the service was not appropriately authorized.

Therefore you appear to be in violation of California Health & Safety Code Sec. 1371 (see

language below). We expect full payment due for these services to be remitted to us at once,

along with applicable interest due under the statute. Continuing violation of this statute will

be reported to the California Department of Insurance or Department of Corporation as

applies to your plan.

HSC Sec 1371 A health care service plan...shall reimburse claims or any portion of any

claim, whether in state or out of state, as soon as practical, but no later than 30 working days

after receipt of the claim by the health maintenance organization, 45 working days after

receipt of the claim....If an uncontested claim is not reimbursed by delivery to the claimant’s

address of record within the respective 30 or 45 working days after receipt, interest shall

accrue at the rate of 10 percent per annum beginning with the first calendar day after the 30

or 45 working day period....If a claim or portion thereof is contested on the basis that the plan

has not received all information necessary to determine payer liability for the claim or portion

thereof and notice has been provided pursuant to this section, then the plan shall have 30

working days, or if the health care service plan is a health maintenance organization, 45

working days after receipt of this additional information to complete reconsideration of the

claim.

© The Sage Associates, 1997 reimb./apealtr

Denial of Service of Alleged Failure to Meet Medical Necessity
After Prior Authorization Received

Attached is a copy of our claim for services for your insured and copy of prior authorization
we received from you. Your denial of the claim appears both inappropriate and also appears
to be a per se violation of California Health & Safety Code Sec. 1371.8 (see language below).
We expect prompt reimbursement of this claim. If we fail to receive reimbursement within
the next 10 working days, we will be forced to refer this issue to the California Department
of Corporations or Department of Insurance, as applies to your plan.

HSC Sec.1371.8 A health care service plan that authorizes a specific type of treatment by a
provider shall not rescind or modify this authorization after the provider renders the health
care service in good faith and pursuant to the authorization.

© The Sage Associates, 1997 reimb./apealtr

Denial of Service for Alleged Failure to Meet Medical
Necessity

Attached is a copy of our claim for services for your insured, for which you have denied
payment, alleging lack of medical necessity. We urge immediate reconsideration of this
action. The denial of services appears to be a per se violation of Health & Safety Code
Section 1370.2 (see language below).

In order to determine if this violation requires us to report this incident to the California
Department of Insurance or Department of Corporations, as applies to your health plan,
please advise us of the name, qualifications, training, background and relevant expertise of
the reviewer that denied the claim in question. If you consider the reviewer’s identity to be
confidential, then provision of the other information about the reviewer is still required
pursuant to HSC Sec. 1370.2

We expect reconsideration of this claim or provision of this required information to be
provided within the time frames specified by HSC 1371. Thank you for your consideration.

HSC1370.2 Upon an appeal to the plan of a contested claim, the plan shall refer the claim
to the medical director or other appropriately licensed health care provider...If...he or she is
not competent to evaluate the specific clinical issues of the appealed claim, prior to making a
determination, he or she shall consult with an appropriately licensed health care provider who
is competent to evaluate the specific clinical issues presented in the claim...(which) means
that the reviewer has education, training, and relevant expertise that is pertinent for
evaluating the specific clinical issues that serve as the basis of the contested claim. The
requirements of this section shall apply to claims that are contested on the basis of a clinical
issue, the necessity for treatment or the type of treatment proposed or utilized.

© The Sage Associates, 1997 reimb./apealtr

Denial of Service Based on Inappropriate or
Undocumentable Practice Guidelines

Attached is a copy of our claim for services for your insured, for which you have denied
payment alleging lack of medical necessity. We urge your immediate reconsideration of this
action. A copy of all referable chart notes, supporting reports and other explanatory material
is attached.

In our view, your denial of this service is not consistent with professionally accepted
standards for judging medical necessity. For example, be aware that the American College of
Physicians has established as official policy the following definition of medical necessity:

‘A test, procedure or investigation is medically appropriate if documentation
supports that the results of the test, procedure or investigation would alter or influence
the diagnosis, course of treatment or prognosis of the patient’s illness, disease or
disability.’

All of the tests and treatments which were performed in connection with this claim clearly
meet the requirements of this policy statement. Furthermore:

‘Appropriateness cannot be fairly judged by third parties except against standards
based on scientifically acceptable data or professional consensus, as described in
published documents. Such data and standards should be publicly available, explicitly
referenced by the reviewer and rationale provided for denying a procedure if the
practitioner’s judgment is contradicted in post-payment review or in medical necessity
determination prior to payment.’

Should any of the services performed referenced in the claim be declared by your reviewer to
not be medically necessary, please be advised that I fully expect the reviewer to comply with
these policies, with disclosure of the reviewer’s appropriate training and background in this
clinical area, and with appropriate references which support the reviewer’s position in this
clinical case.

© The Sage Associates, 1997 reimb./apealtr

Late Payment - Sample Letter Demanding Payment of Non-Emergency Service Claims with Interest
[Physician Letterhead]

Date:

Re: Patient Name:
Insurance Carrier I Health Plan I IPA
Insurance ID Number:
Date of Service:
Billed Amount:
Payment Received:
Balance Due:

Dear [plan Administrator; IPA or Other Contracting Entity or DHS]:

We have not yet received [or have only received partial] payment for services provided to [Patient] on
[Date of Service] in the amount of [Claim Amount]. The claim was sent to [Name of PlanlIPA or other
contracting entity] on [Date Claim Sent].

Under California law, HMOs (and their contracting entities) are required to pay uncontested claims
within 45 days, and other third-party payors (and their contracting entities) within thirty (30) days. If the
claim is contested or denied, the plan must provide such written notice within the 30 or 45-day period.
(Contested claims must be paid within the same time periods, after further required information has been
sent.) [Under California law, DHS must make payment for claims by a small business or nonprofit
organization within 30 days after a claim is received, unless reasonable cause for nonpayment exists.]
[Under Medicare I am also entitled to receive payment for all clean claims within thirty (30) days.]

Otherwise, interest accrues on the late payment of full or partial claims at 15% per year for HMOs and
other Knox-Keene plans (see Health & Safety Code §1371); 10% per year for health insurers (see
Insurance Code §10123.13); approximately 3.25% per annum for Medicare (see 42 U.S.C.
§1395u(c)(2)(B)) or 0.25% per calendar day for Medi-Cal (see Government Code §927.6). To date we
have not received notice that this claim is being contested.

We are writing this letter to demand payment of the above-referenced claim in the amount of [Claim
Amount] plus [15%] [10%] [3.25%] [0.25%] interest [per year] [per day].

[Moreover, because interest was owed commencing [date] , and was not paid automatically as

required by Health & Safety Code §1371 and 28 C.C.R. §1300.71G), we further demand the statutory

surcharge of $10.00 per claim, for a total surcharge of $ . If we do not receive payment in this

amount by [Date], we will consider legal action. Thank you in advance for your anticipated

cooperation. ]

Sincerely,

[Name of Physician]

cc: [Department of Managed Health Care]
[Department ofI nsurance]
[Department of Health Services]
California Medical Association

11

Sample Verification of Benefits Appeal Letter

Date
Attn: Director of Claims
Insurance Policy Carrier
Insurance Policy Address

Re: Patient: Patient Name
Policy: Insurance Policy Number
Insured: Responsible Party Name
Treatment Dates: Admission Date - Discharge Date
Amount: Total Charges

Dear Director of Claims,
The above referenced claim was denied despite the fact that verification of benefits and/or preauthorization of
care was obtained from your company. Please be advised, our facility relies on information received from your
company regarding coverage. We extended treatment in good faith based on the expectation of payment as
quoted by your company.
Many state courts have held that insurers can be liable for misrepresentations made during coverage
verification and utilization review. Such rulings often rely on the legal theory of equitable estoppel wherein a
party who makes a misstatement of fact is estopped from denying another party the right of benefits when that
party relied on incorrect information to his or her detriment.
Further, most states have an Unfair Claims Settlement Practices Act prohibiting licensed insurance companies
from knowingly misrepresenting material facts or relevant policy provisions in connection with a claim. It is
our position that your duty as the insurer is to provide accurate information at the time of verification of
benefits/utilization review.
Based on this information, we request immediate payment of the above referenced claim in accordance
with the benefits quoted at the time of the patient's admission. We request a response to this appeal
within 14 days of your receipt.
Sincerely,

Patient Accounts Manager

------------- ----------------------------------------------------------------------------

“Prompt Pay” Statutes
and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Alabama Clean claims paid within 45 Timikel Robinson
Alaska working days, applies to (334) 206-5366 www.ADPH.org
Arizona HMO’s only. Alabama Dept. of
Arkansas Public Health
California
Clean claims must be paid Katie Campbell http://old-
Colorado within 30 working days. (907) 465-4607 www.legis.state.ak.us/cgi-
Connecticut Alaska Div. of bin/folioisa.dll/stattx01/quer
Insurance y=/doc/{t8722}

Clean claims must be paid Deborah Claw http://www.id.state.az.us/pu
within 30 days or interest (602) 912-8444 blications/timely_pay.pdf
payments are required (usually Arizona Dept. of
about 10%) Insurance http://www.state.ar.us/insur
Clean, electronic claims must Rosalind Minor (501) ance
be paid or denied in 30 371-2766
calendar days, paper in 45. Arkansas Dept. of (Click on Insurance Laws,
12% per annum interest after Insurance Rules, and Regs #43)
60 days. http://www.hmohelp.ca.gov/
Claims must be paid within 45 (800) 400-0815 library/statutes/knox-
working days for an HMO, 30 California Dept. of keene/_Toc32032014
days for other health service Managed Health
plans. Interest accrues at 15% Care http://198.187.128.12/color
per annum or $15 penalty, ado/lpext.dll?f=templates&f
whichever is greater. Michael Gillis n=fs-main.htm&2.0
Claims must be paid in 30 (303) 894-7499
calendar days if submitted Colorado Div. of http://www.ct.gov/cid/cwp/vi
electronically, 45 if paper. Insurance ew.asp?a=1267&q=254456
10% annual interest penalty. Email
Claims must be paid within 45 gerard.o’sullivan@po
days. Interest accrues at 15% .state.ct.us
per annum. (860) 297-3889
Connecticut Dept. of
Ins

1

“Prompt Pay” Statutes

and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Delaware Clean claims must be paid in Johnii Bothell
Dist. of Columbia 30 days. (302) 739-4251x123 http:disr.dc.gov/news_room
Delaware Dept. of /2003/February/02_05_03.s
Florida Clean claims will be paid in 30 Insurance htm#top
days. Interest payable at 1.5% Evette Alexander
Georgia days 31-60, 2% days 61-120, (202) 442-7786 http://www.flsenate.gov/statut
and 2.5% after 120 days. Health Policy Advisor es/index.cfm?App_mode=Dis
Applies to claims received on Dist. Of Columbia play_Statute&Search_String=
or after October 16, 2002 Dept. of Ins &URL=Ch0627/SEC613.HTM
Clean HMO claims (paper or &Title=->2002->Ch0627-
electronic) must be paid in 35 Health Ins. Division >Section%20613
days, non-HMO in 45 days. Pam White
Claims where information was (850)-413-3132 http://www.legis.state.ga.us/cg
requested must be paid in 120. Florida Dept. of i-
Interest penalty is 10% per Insurance bin/gl_codes_detail.pl?code=3
year. Statute # 31555 3-24-59.5
Claims must be paid within 15 Yvonne Jones
working days. Interest accrues (404) 656-2164
at 18% per annum. Georgia Office of Ins.
Comm.

Hawaii Clean, paper claims must be Paula Arcena www.state.hi.us
paid in 30 days, electronic (808) 536-7702
Idaho claims within 15 days. Interest Hawaii Medical http://www.doi.idaho.gov
Illinois accrues at 15% per annum. Association
Commissioner may impose www.legis.state.il.us
fines. Joan Skrosch Go to Senate Bill 251-
Paper Claims Settled in 45 (208) 334-4300 1255-71a
days & electronic Claims in 30 Idaho Dept. of
days – Chapter 56 Insurance
(217) 524-4051
Clean claims must be paid in Illinois Dept. of
30 days. Interest accrues at Insurance
9% per annum. 1-877-527-9431 (toll
free)

2

“Prompt Pay” Statutes

and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Indiana Paper claims must be paid in (317) 232-2395
Iowa 45 day. Electronic claims must Cindy Tompkins http://www.in.gov/idoi/healt
Kansas be paid in 30 days. Indiana Dept. of h/payments.html
Kentucky Insurance
http://www.legis.state.ia.us/IA
Louisiana Payment to be made in 30 Robin Spencer CODE/2001SUPPLEMENT/5
days. Penalty is 10% per (515) 281-5523 07B/4A.html
Maine annum. Iowa Div. of
Maryland Insurance http://www.kslegislature.org
Massachusetts Claims will be paid in 30 days. Steve O’Neil /cgi-bin/statutes/index.cgi
Interest accrues at a rate of (785) 296-7826
1% per month. Kansas Dept. of http://www.lrc.state.ky.us/K
Insurance RS/304-
Claims must be paid or denied Daryl Thompson 17A/CHAPTER.HTM
within 30 calendar days. (800) 595-6053
Interest accrues at 12% per X 4303 (Click .702 and .730)
annum when 31-60 days late, Kentucky Dept. of
18% 61-90 when days late and Insurance http://www.ldi.state.la.us/off
21% when 91+ days late. ice_of_health/quality_mana
gement/qm_reg74.htm
Claims submitted electronically Cheryl Gordon
must be paid within 25 days. If (225) 219-9524 http://janus.state.me.us/legi
not paid within 25 days the Louisiana Dept. of s/statutes/24-A/title24-
health insurance issuer shall Insurance Asec2436.html
pay to the claimant an www.maineinsurancereg.or
additional late payment Rick Diamond or g
adjustment equal to 1 percent JoAnne Rowlings http://mlis.state.md.us/1999
of the unpaid balance due for (207) 624-8428 rs/billfile/hb0639.htm
each month. Maine Bureau of
Clean claims must be paid Insurance. (Click on House Bill 639)
within 30 days. Interest Jama Allers
accrues at 1.5% per month. (410) 539-0872
The Maryland State
Clean claims must be paid Medical Society
within 30 days. Interest
accrues at monthly rates of Nancy Schwartz
1.5% (31-60 days late), 2% (617) 521-7347
(61-120), and 2.5% (121+) Massachusetts Div.
respectively. of Ins.
MCL 500.2006
MCL 200.111

3

“Prompt Pay” Statutes

and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Michigan A clean claim submitted to an Carol Rall
Minnesota insurance co. with all the (877)-999-6442 http://www.michigan.gov/mi
Mississippi correct information shall be Michigan Dept. of newswire/0,1607,7-136-
Missouri paid within 45 days. Penalty is Insurance 3452_3482-35876--
12% interest. The bills also M_2002_5,00.html
Montana hold Medicaid and HMO’s to Irene Goldman
this 45 day schedule. (651) 282-6327 http://www.revisor.leg.state.
Clean claims must be paid in Minnesota Dept. of mn.us/stats/62Q/75.html
30 days. Interest accrues at Health
1.5% per month if not paid or Kathy Vernon www.sos.state.ms.us
denied. (601) 359-3569
Clean claims must be paid Mississippi Dept. of http://www.house.state.mo.
within 25 days if electronic, 35 Ins. us/bills01/bilsum01/truly01/
days if paper claim. Interest shb328t.htm
accrues at 1.5% per month. .

Claims must be acknowledged Thomas Holloway
within 10 days & paid or (573) 636-5151
denied within 15 days of Missouri State
receipt of requested additional Medical Assoc.
information. Interst penalty of
1% per month applies to Ron Herman
claims not paid within 45 days. (406) 444-5239
After 40 processing days Montana Dept. of
provider is entitled to a per day Insurance
penalty: 50% of claim (up to
$20) if they notify the carrier.
This penalty will accrue for 30
days only, unless the provider
served notice again. Rules
also stipulates that re-
contracted providers may file
claims up to one year from
date of service; contracted
providers for 6 months unless
contract states otherwise.
Refunds can’t be requested
after 12 months.
Clean claims must be paid
within 30 days. Interest
accrues at 18% per annum.
Montana annotated code 33-
18-232.

4

“Prompt Pay” Statutes

and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Nebraska Claims must be paid or denied Scott Zaeger
Nevada with in 15 days of affirmation of (402) 471-0888 http://www.nol.org/home/S
New Hampshire liability. Nebraska Dept. of OS/Rules/ins/ins61.htm
New Jersey Insurance
Claims must be paid in 30 Kent Royal http://gencourt.state.nh.us/rsa/
days. Penalty interest accrues (702) 486-4009 html/XXXVII/415/415-6-h.htm
at rate set forth in Nevada Nevada Insurance
Revised Statute 99.040. Division
Effective Jan 1, 2001 clean Pauline Lamy
paper claims must be paid in (603) 271-2261
45 days, electronic in 15. New Hampshire
1.5% monthly interest penalty. Dept. of Ins.
Clean, electronic claims must Veronica Schmidt
be paid within 30 days, paper (609) 292-5316
claims within 40 days. ex. 50528
New Jersey Dept. of
Health

New Mexico Clean claims must be paid Fred Couty http://legis.state.nm.us/lis/d
New York within 30 days if electronic, 45 (505) 827-4545 efault.asp
North Carolina days if paper. Interest accrues New Mexico Dept. of
North Dakota at 1½% per month. Ins. (click New Mexico statutes, click
N.M. statutes annotated, click
Claims must be paid with 45 days. Moe Auster (518) through to 59A-2-9.2)
Interest accrues at greater of 465-8085
12% per year or corporate tax New York Medical http://www.ncga.state.nc.us
rate determined by Society /Statutes/EnactedLegislatio
Commissioner. Fines up to n/Statutes/HTML/BySection
$500/day possible. Terrry Lorry /Chapter_58/GS_58-3-
Claims must be paid or denied (919) 733-2032 225.html
within 30 days. Annual interest No. Carolina Dept. of www.state.nd.us/lr/index.ht
penalty of 18%. Ins. – Managed Care ml
Dept.
Claims must be paid within 15 Cydra Sauter (Click 26.1, look for 26.1-36-37.1)
days. 1-800-247-0560
No. Dakota Dept. of
Ins.

5

“Prompt Pay” Statutes

and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Ohio Payor must notify provider within Tate Chaney
Oklahoma 15 days of receipt if claim is (614) 644-2658 www.ohioinsurance.gov
materially deficient; payor must Ohio Dept. of Click file a complaint
process claims in 30 days if no Insurance Provider complaint
supporting documentation is Prompt Pay
needed. If payor requests Sam Simms
additional information (must be (405) 222-4864 www.lsb.state.ok.us
done within 30 days of receipt of Lydia Shirley 405- Click OK Statutes &
claim). Claim must be processed 521-6624 Constitution, Statute
in 45 days from receipt of Oklahoma Dept. of database 63-2514
requested information. Health
Carolyn Hancock www.oregoninsurance.org
Clean claims must be paid (503) 947-7205 Click rules 743.866
within 45 days. Penalty of 10% Oregon Dept. of
of claim as interest for late Insurance http://www.pacode.com/sec
claims. Pete Salvatore ure/data/031/chapter154/s1
(717) 783-0442 54.18.html
Oregon Effective Jan. 1, 2002 clean Pennsylvania Ins.
Pennsylvania claims must be paid in 30 Dept. http://www.rilin.state.ri.us/st
Rhode Island days. 12% interest penalty Rollin Bartlett atutes/title27/27-18/27-18-
South Carolina applies. (401) 222-2223 61.htm
Clean claims must be paid in Rhode Island Dept.
45 days. Provider must be of Ins. www.lpitr.state.sc.us
licensed in Pennsylvania Ann Bishop
(803) 737-6165 (Click on research, code of Laws,
Written claims to be paid in 40 South Carolina Dept. By title/chapter, Title 38, Chapter
calendar days, electronic in 30 of Ins. 71, scroll down to section 735)
days.

Group health insurers must
pay claims in 60 days.

South Dakota Electronic claims must be paid Randy Moses http://legis.state.sd.us/sessi
Tennessee in 30 days, paper claims in 45. (605) 773-3563 ons/2001/bills/SB231SHE.
So. Dakota Dept. of htm
Clean, commercial claims sent Ins.
electronically must be paid Susan Wittig www.tennessee.gov.
within 21 days, paper claims in (615) 741-2199 Laws & Justice
30 days. Interest accrues at Tennessee Dept. of Laws & Rules
1% per month. Ins. – Legal Dept. TN Code & Constitution 57-7-
109

6

“Prompt Pay” Statutes

and Regulations

State Status/Terms of Law State Contact Website Address
(If Available)
Texas Effective 9/1/03 Paper claims Pat Brewer
Utah to be paid in 45 days and (512) 305-7277 http://www.capitol.state.tx.u
electronic in 30. Interest Texas Dept. of s/statutes/in/in0020A00.ht
Vermont accrues at 18%. Insurance ml#in038.20A.18B.
Virginia Effective 9/1/01 claims must Liz Kneisley or
Washington be paid or denied in 30 days. (801) 538-3800 http://www.le.state.ut.us/~2
West Virginia Penalty interest may be Cheryl Alexander 001/bills/sbillenr/SB0069.ht
Wisconsin applied according to formula. (801) 538 3820 m
Utah Dept. of
Claims must be paid or denied Insurance http://www.leg.state.vt.us/statu
in 45 days. Interest penalty is (802) 828-3301 tes/fullsection.cfm?title=18&ch
12% per annum. Vermont Dept. of apter=221&section=09418
Insurance
http://leg1.state.va.us/000/l
Clean claims must be paid Bill Cramme st/LH807640.HTM
within 40 days. (804) 786-3591 chapter 38.2-3407.15
Virginia Legislative
95% of the monthly volume of Services www.insurance.wa.gov
clean claims shall be paid in John Hetiguard
30 days. 95% of the monthly (360) 725-7000 (Click on rules/laws, click on 284
volume of all claims shall be Washington Ins. WAC Insurance Regs., click on
paid or denied within 60 days. Comm. 284-43, then 284-43-321)
Claims must be paid in 30
days if electronic, 40 days if Denna Wildman http://129.71.164.29/wvcode/3
paper. Interest and fines may (304) 558-3386 3/WVC%2033%20%20-
apply. Interest penalty of 10% West Virginia Div. of %2045%20%20-
per annum. Ins. %20%20%202%20%20.htm
If clean claims are not paid
within 30 days they are subject Stephanie Cook http://www.legis.state.wi.us/
to a penalty interest rate of (608) 261-8563 rsb/statutes.html
12% per year. Wisconsin Dept. of
Insurance (Click 628, then 628.46)

Wyoming Claims must be paid within 45 Lloyd Wilder or Mark http://legisweb.state.wy.us/
days. Penalties and fines may Pring statutes/titles/title26/chapte
accrue. (307) 777-7401 r15.htm
Wyoming Dept. of
Insurance (Scroll down to 26-15-124)

7