OIG targets health plan for prompt pay violation
Compliance Monitor, July 14, 2004
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Providence Health Plans was the target of an OIG audit that found the plan to be noncompliant with prompt payment regulations for Medicare + Choice.
The OIG, which released a report on the audit July 7, investigated whether the plan complied with Medicare + Choice prompt payment regulations to timely pay or deny claims submitted by noncontracted providers from September 1, 2002 through February 28, 2003.
The OIG found that Providence did not comply with prompt payment regulations for the following reasons:
Providence didn't have adequate procedures in place to pay or deny claims in a timely manner and process resubmitted claims, the report stated.
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