11 N.C. Admin. Code 18 .0112 - CLAIMS PAYMENTS
In order to assure that all valid claims for payments for benefits provided are paid within a reasonable time, the following standards apply:
(1) Each MEWA shall pay within
30 days of receipt by the MEWA or its administrator, if applicable, all valid
claims for benefits.
(2) If the
MEWA requires additional information, the MEWA shall request such additional
information in writing within the 30-day period; and upon receipt of the
additional information, the claim shall be paid within 30 days of receipt of
the additional information.
(3) If
the claim is denied, the MEWA shall provide the reason or reasons for the
denial in writing to the claimant and the claimant's health care
provider.
Notes
Eff. July 1, 1992;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 16, 2014.
Eff. July 1, 1992.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.