Subtitle 10 - CLAIMS AND UTILIZATION REVIEW
- Section 15-1001 - Requirement for utilization review
- Section 15-1002 - Claim forms to conform to regulations
- Section 15-1003 - Adoption of uniform claims forms required
- Section 15-1004 - Acceptance of uniform claims forms required
- Section 15-1005 - [Effective Until 5/18/2025] Prompt payment of claims
- Section 15-1005 - [Effective 5/18/2025] Prompt payment of claims
- Section 15-1006 - Notice of reason for denial of claim
- Section 15-1007 - Summary explanation of benefits
- Section 15-1008 - Retroactive denial of reimbursement
- Section 15-1009 - "Carrier" defined; reimbursement for preauthorized care; payment of claims
- Section 15-1010 - "Disability benefit" and "adverse benefit determination" defined; regulations
- Section 15-1011 - Expense reimbursement claims forms - Methods for submission