P.R. Laws tit. 26, § 9091
2019-02-20 00:00:00+00
(a) A health insurance organization or issuer shall make prompt payment of a bill in accordance with the provisions of §§ 301–335 of this title and shall not delay payment for an audit process. Payment on a submitted bill from a third-party shall be based on amounts billed and covered by the patient’s health plan.
(b) Audit fees shall be paid upon commencement of the claim audit.
(c) A payment identified in the audit results that is owed to either party by the other, shall be settled by the audit parties within a reasonable period of time not to exceed thirty (30) days after completion of the audit unless the parties agree otherwise.
History —Aug. 29, 2011, No. 194, § 6.110, eff. 180 days after Aug. 29, 2011.