The following is some general information concerning the ability of a health plan to place physicians special claims review and seek copies of the physician’s medical records for the purposes of paying a claim.
2019 Health Law Library
Reimbursement: From Private & Public Payors
- Assignment of Benefits
- Authorization and Payment for Emergency Services
- Bankruptcy of IPAs or Health Plans
- Coordination of Benefits
- Coordination of Benefits: Payment Below Medicare Allowable
- Covered California: California's Health Benefits Exchange
- ERISA Plans
- Fee Schedules
- Health Plan Special Claims Review
- Insolvency of Health Plan, IPA or Other Entities that Contract with Health Plans (Pre-Bankruptcy or
- Late Payment
- Non-Contracting Physicians
- Payment Denial after Treatment Authorization or Verification of Eligibility
- Payment Denials by Managed Care Plans and IPAs
- Plan Requests for Refunds from Physicians
- Reimbursement for Immunizations and Other Injections (2005)
- RICO Settlements (2014)
- Silent PPO Action Guide
Document Details
Health Plan Special Claims Review
The following is an introduction to the document. To download the full text of the document, please log in.