Do providers have a time limit under state regulations to submit a claim for payment after a date of service?
A. In general, L.R.S. 22:213 (5) “Proofs of Loss” gives the provider 90 days to file a claim. It states “Affirmative written proof of loss must be furnished to the insurer at its said office in case of claim for loss of time from disability within ninety days after the termination of the period for which the insurer is liable and IN CASE OF CLAIM FOR ANY OTHER LOSS WITHIN NINETY DAYS AFTER THE DATE OF SUCH LOSS (emphasis added).” A carrier may certainly give a provider more time to file a claim, and this is usually addressed in the contract between the health insurer and the provider or in the insured’s policy.
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