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What is the file limit for healthcare cliams to be submitted to insurance companies for the state of Michigan? |
I'm already aware that doctor's sign contracts with insurance carriers that limit the time they have to submit billing to insurance carriers, but I also understand that each state has there own rule on the amout of time that doctors can send claims to insurance companies, I need to know where to find out this info. and which supersedes. The following is from the Michigan Department of Labor & Economic Growth, which oversees MI health plans (link below). The last paragraph is what you鈥檇 be interested in. I would contact the office directly to see what the rules are鈥?br /> 鈥淗ow do I let the insurance company know when I have a claim? Written notice of claim must be given to the insurer within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at the insurer鈥檚 home office, or to any authorized agent of the insurer, with information sufficient to identify the insured, will be considered notice to the insurer. When the insurance company receives notice of claim, it will furnish forms for filing proof of loss. If the forms are not furnished within 15 days after giving notice, the insurance company must consider that the insured had complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made. Written proof of loss must be furnished to the insurance company within 90 days. Failure to furnish the proof within the time required will not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than 1 year from the time proof is otherwise required.鈥?br /> Hope this helps, Barnes@MostChoice http://www.mostchoice.com/health-insuran... Source(s): Michigan Department of Labor & Economic Growth (Health Insurance) http://www.michigan.gov/cis/0,1607,7-154... I am not aware of state rules for this. I have never run into state issues. The company sets the limit. The states usually make sure they follow what they say. |
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