texas clean claim recoupment

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LAWS THAT PROVIDE REGULATION OF THE BUSINESS ...

Recoupment of claims has to be based on actual overpayment unless it is part of a . Clean claims filed electronically must be paid within 15 days (not later than 35 . the Employee Retirement System of Texas is not required to select the .
http://www.ncpanet.org/pdf/leg/leg_pbm_business_practice_regulation.pdf


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TrailBlazer Bulletin - July 2012 - TrailblazerHealth.com

HPSA 2012 Primary Care ZIP Code File Issue for Texas ZIP Code 78648 [B]. . Requesting Immediate Recoupment for Demanded Part B Overpayments [B]. . July 2012 Prompt Payment Interest Rate on Clean Non-PIP Claims Not Paid Timely .
http://www.trailblazerhealth.com/Publications/Newsletter%20-%20eBulletin/TrailBlazerBulletinJuly2012.pdf


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      Prompt Pay of Clean Claims - Harris County Medical Society

      Dec 22, 2011 . The Texas Department of Insurance (TDI) is the state agency responsible . SB418 is the current prompt pay/clean claims law effective for contracts that . are also defined, as well as overpayment/recoupment requirements.
      http://www.hcms.org/Template.aspx?id=83


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      Chapter 5 Texas Workers' Compensation ... - sebin.pbworks.com

      Jan 7, 2008 . Texas Clean Claim and Electronic Medical Billing and Payment . Request of recoupment for an overpayment made to a health care provider.
      http://sebin.pbworks.com/f/Texas%20Workers'%20Compensation%20Requirements.pdf


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      HMO Blue® Texas Online Orientation Check List - Blue Cross and ...

      HMO Blue Texas Physician & Other Professional Provider – Provider Manual - under Provider . Claims Submission; Proof of Timely Filing; Clean Claim Information; Claim Appeal/Reconsideration Review Process; Refunds & Recoupments. 8.
      http://www.bcbstx.com/provider/training/hmo_blue_orientation.html


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      BlueChoice ® Online Orientation Check List - Bcbstx.com

      Producers · Providers · Blue Cross Blue Shield of Texas – Health Insurance . Claims Submission; Proof of Timely Filing; Clean Claim Information; Claim Appeal/Reconsideration Review Process; Refunds & Recoupments. 8. Filing Claims .
      http://www.bcbstx.com/provider/training/bcs_orientation.html


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      Download the PDF file - Aprx.org

      As the Texas pharmacy industry knows, audits by insurance companies and . already submitted via affirmative adjudication and resolved as a clean claim . recoupments, it is essential to know how to prepare for and handle an on-site audit.
      http://www.aprx.org/documents/on-site-audit.pdf


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      Great-West Compliance Provisions - ValueOptions

      The term “Clean Claim” shall be replaced by the following, and to the extent not . adjustments of claims, including any recoupment or refund of a paid claim. If .
      http://www.valueoptions.com/providers/Network/Great_West/GW_State_Compliance_provisions_GW_PR_Handbook.pdf


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      PLENDIL FOR SALE | Physicians News

      Sep 6, 2011 . Medicare also has a recoupment process for overpayments. . Under ERISA, any determination that a claim should not be paid in full . Life and Annuity Insurance Co., 467 F.Supp.2d 705, 710 (S.D. Tex. . Keep it clean.
      http://www.physiciansnews.com/2011/09/06/retroactive-adverse-benefit-denials-under-erisa/


      http://en.wikipedia.org/wiki/Natalia_Villaveces

      http://www.indyscan.com/county/porter.htm

      SUGGESTIONS TO RAISE REVENUE FOR EMS IN KENTUCKY

      need to define what a clean claim is, have different prompt pay expectations by electronic filing and . Limit insurance time to deny and recoup their money. Especially . days, define clean claim as Tennessee or Texas regulation. ( attached) if .
      http://www.911billing.net/kapafolder/kaparevenue.pdf


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11.901 - : Texas Administrative Code

(8) regarding prompt payment of claims as described in the Insurance Code . to prompt payment of clean claims, including Insurance Code Chapter 843, . by or on behalf of the contracting physician or provider, including recoupment; .
http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=28&pt=1&ch=11&rl=901


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