Wiki Ins Refund laws for the State of Illinois

[smartcoder]

As per my understanding insurance can recoup or request refunds for the payments issued in last 18 months. I was trying to find some supporting documentation but there was nothing specifically for the state of Illinois. We have BC IDPA and BCBS coming back from 2014-2015 and taking the payments back. This is getting out of control now. Please help.

 

[JJOHN0312]

Insurance Law in Illinois

I am not sure about this one. Maybe you can find some information here. http://insurance.illinois.gov/

Josie

 

[thomas7331]

Here's a link to the statute in IL: http://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=097-0556

Keep in mind though that, state governments only have jurisdiction over fully insured plans operating within their states. In addition to those exceptions listed in the law that allow for recoupment beyond 18 months, large insurance companies may also process claims for self-funded plans and other out-of-state entities and policies which are not necessarily subject to state insurance regulations, so it not uncommon to see recoupments beyond a state's time limit for those types of claims.

 

[GCLindsay]

Bcbs il

Federal guidelines allow payers to review and take back payments for as far back as 7 years. To add insult to injury, BCBSIL can take as long as 2 years to complete a recoupment after you've been notified but that can be expedited by submitting a request to either your territory rep or through the Availity portal, the latter being their preferred channel.