IA HF637

Dental carriers must establish written policies and procedures allowing dental care providers to appeal overpayment recovery requests, with a minimum 90-day window to file an appeal after receiving notice

Carriers cannot attempt to recover overpayments unless they provide written notice to the provider within 365 calendar days of the overpayment date, identifying the specific error in processing or payment

Carriers may recover overpayments by withholding or reducing payments on different claims, but must notify providers in writing within 28 calendar days identifying the original overpaid claim and amounts being withheld

Notice and timing requirements do not apply when overpayment recovery efforts are based on reasonable belief of fraud, abuse, or other intentional misconduct

Requirements cannot be waived by contract, and any contract provisions contrary to the bill are null and void; the Insurance Commissioner may adopt administrative rules to implement the law