What are the time frames that a health insurance carrier must follow in paying a health insurance claim timely?
A. According to Louisiana Act 1017 in 1999, a health insurer must pay a clean claim filed electronically in 25 days, unless the insurer chose a 30-day across the board standard for both electronic and non-electronic claims. A non-electronic clean claim submitted by a non-contracted provider must be paid with 30 days of submission. A non-electronic clean claim submitted by a contracted provider within 45 days of date of service must be paid within 45 days and a non-electronic claim submitted by a contracted provider within 60 days of date of service must be paid within 60 days. For more information on Timely Payment of Health Coverage Claims, please refer to our website for reference to Regulation 74 and R.S. 22:250.31 through 250.37.
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