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Home Health & Hospice Week

Managed Care:

Overcome Delinquent Payor Headaches By Knowing Your State's Prompt Pay Laws

Published on Fri Jan 14, 2011

Remember: Medicare requires contractors to pay your clean claims within 30 days, but private payers differ by state. Providers with managed care patients may find this scenario all too familiar: You've submitted a claim that you know is clean, you've waited three months, and you still haven't collected. Do you have any recourse? Yes, thanks to the prompt pay laws that each state must follow when paying your medical claims. Determine Which Prompt Pay Laws Apply to You Each state requires private insurers to pay all clean claims within a certain time frame. If the insurer does not pay the claim in a timely manner, then the payer is subject to paying interest on the charges owed to the provider (or directly to the beneficiary). Although each state publishes its own individual law, most range from 15 to 45 working days, with 30 days about the average. How to find [...]
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