DE HB146

Limits post claim adjudication audits by carriers to 400 claims per provider for a specific episode of care within a 45-day period, with written requests required.

Requires providers to submit audit records within 45-60 days of request and allows 30-60 days to appeal audit determinations.

Establishes a minimum 180-day window from service date for providers to submit claims for reimbursement, regardless of network status.

Mandates carriers accept primary and secondary electronic claims from all providers regardless of network status and acknowledge receipt within two business days.

Requires carriers to provide electronic remittance advice (ERA/835) files to providers upon completion of necessary agreements.