Advanced Search

Pediatric Coding Alert

Practice Management:

Know Your State's Prompt Pay Laws -- And Appeal When Necessary

Published on Fri Aug 27, 2010

Medicare requires contractors to pay your clean claims within 30 days, but private payers differ by state.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. What are prompt pay laws: 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 practice (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 yours: "If you are a little adventurous, you could search for your state law on the Internet, although [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pediatric Coding Alert

View All