Section 230-RICR-20-30-6.2 - Purpose and ScopeA. This Part is designed to effectuate administration and enforcement of Rhode Island's prompt processing statutes, set out at R.I. Gen. Laws §§ 27-18-61, 27-19-52, 27-20-47 and 27-41-64.B. This Part, like the state's prompt processing statutes, is very broad in scope. The prompt processing requirements established by R.I. Gen. Laws §§ 27-18-61, 27-19-52, 27-20-47 and 27-41-64 apply to all health insurers, health plans, dental plans, nonprofit hospital and medical service corporations, nonprofit dental service corporations, health maintenance organizations, licensed third party administrators and contractors operating in Rhode Island. These entities and plans are required to process electronic claims submitted by Rhode Island health care providers and policyholders within thirty calendar days from receipt of said claims and to process written claims submitted by Rhode Island health care providers and policyholders within forty calendar days from receipt of said claims.C. These processing requirements apply to all non-federal program claims, regardless of whether such claims are fully insured or self insured. Examples of federal program claims exempt from this Part include claims submitted for payment under the Medicare program and the Federal Employees Health Benefits program (FEHB). The processing requirements set out in this Part do apply to claims submitted for payment under the RIte Care program, but not to claims submitted under other Medicaid programs.D. Entities and plans subject to the prompt processing requirement must also: 1. pay interest on claims not paid within the required timeframes,2. file claims processing reports with the Office of the Health Insurance Commissioner, and3. provide complete claim standards to participating providers.E. In addition, this Part establishes a process for Rhode Island providers to file a prompt processing complaint with the Office of the Health Insurance Commissioner.230 R.I. Code R. 230-RICR-20-30-6.2