Can carriers delay or deny claims processing if they are waiting on information from the member?
A. For members subject to Prompt Pay Legislation, BCBSTX can request information from the treating physician without finalizing claim payment. If there is any other information needed from another source, we will not delay payment. Upon receipt of the additional information from the other source, if the information alters our decision, additional payment of refund notice will be issued accordingly.
Related Questions
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