How long does an insurance company have to pay a claim from a non-contracted provider?
When there is no contractual relationship between the physician or provider and the insurer, the insured may make an assignment of benefits to the physician or provider. This includes instances in which an insured in a fee-for-service or indemnity plan makes an assignment of benefits to a physician or provider or if an insured in a preferred provider plan receives services from a non-network provider and makes an assignment of benefits. Under Article 3.51-6, §1(d)(2)(x) (group health plans) and Article 3.70-3, §(A)(8) (11) (individual policies) of the Texas Insurance Code, the insurer must pay all benefits payable under the policy within 60 days after receipt of proof of loss.
Related Questions
- How long does an insurance company have to pay on a claim (such as a theft under my renters insurance)? Are there laws stating a certain period of time that a company would have?
- What happens when the insurance company sends the payment for a claim to the patient rather than the provider? Can we bill the patient the entire amount?
- How long does an insurance company have to pay a claim from a non-contracted provider?
