CT SB00393

Extends claim payment deadlines from 45 days to 60 days for paper-filed claims and establishes 15-day deadline for electronically filed claims; maintains 30-day deadline for sending notice of claim deficiencies and adjusts payment timeline to 30 days for paper claims and 15 days for electronic claims after receiving requested information.

Directs the Insurance Commissioner to establish procedures for solicitation and maintenance of health care providers in insurer provider networks effective January 1, 2011.

Requires insurers, health care centers, and managed care organizations contracting with health care providers to maintain networks consistent with the National Committee for Quality Assurance's Managed Behavioral Healthcare Organization Standards and Guidelines.

Prohibits utilization review companies from reversing prospective determinations that authorize admissions, services, procedures, or extensions of stay once communicated based on accurate information, and prevents insurers from refusing payment for services provided in reliance on such determinations.

Prohibits dental plan contracts from requiring dentists to provide services or procedures at set fees unless those services or procedures are covered benefits under the enrollee's dental plan.