California Law (Last Updated: March 4, 2014) |
Health and Safety Code - HSC |
Division 2. LICENSING PROVISIONS |
Chapter 2.2. Health Care Service Plans |
ARTICLE 9.5. Claims Reviewers |
Section 1399.55.
Latest version.
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Health care service plans shall, upon rejecting a claim from a health care provider or a patient, and upon their demand, disclose the specific rationale used in determining why the claim was rejected. Nothing in this section is intended to expand or restrict the ability of a health care provider or a patient from having health care coverage approved in advance of services.
(Added by Stats. 1992, Ch. 544, Sec. 1. Effective January 1, 1993.)