La. Admin. Code tit. 37 § XIII-6015
Current through Register Vol. 50, No. 9, September 20, 2024
Section XIII-6015 - Limitations on Claim Filing and AuditsA. Health insurance issuers that limit the period of time that a claim may be filed for payment of benefits shall have the same limited period of time following payment of such claims to perform any review or audit for purposes of reconsidering the validity of such claims. For example, where a health insurance issuer limits the period for filing a claim for benefits to 12 months, then the health insurance issuer shall be limited to 12 months from the date of payment to perform any review or audit of the claim.La. Admin. Code tit. 37, § XIII-6015
Promulgated by the Department of Insurance, Office of the Commissioner, LR 26:2008 (September 2000).AUTHORITY NOTE: Promulgated in accordance with R.S. 22:3, 22:250.35, to implement and enforce the following provisions R.S. 22:230.4(A)(4), Part VI-D of Chapter 1 of the Louisiana Revised Statutes of 1950, and R.S. 40:2203.1.