Okla. Admin. Code § 365:40-5-124

Current through Vol. 42, No. 8, January 2, 2025

Section 365:40-5-124 - Claims payment report

(a) Upon the request of the Insurance Commissioner and in a time frame as specified by the Insurance Commissioner, HMOs shall file with the Department a periodic report on compliance with provisions in Titles 36 of the Oklahoma Statutes and this Part regarding reimbursement of claims within certain time periods.

(b) Each report shall be accompanied by a statement signed by a member of the Board of Directors or executive management attesting to the accuracy of the report.

(c) Any HMO that delegates any claim payment functions shall require the delegated entity or entities to prepare the required report for claims the entity processes including the required attestation.

(d) Each HMO shall collect and submit all required report(s) as a complete package.

(e) These reports shall be in such form and context as directed by the Department.

Okla. Admin. Code § 365:40-5-124

Added at 21 Ok Reg 77, eff 11-1-03 (emergency); Added at 21 Ok Reg 1672, eff 7-14-04