IA HSB190

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

Carriers cannot attempt to recover an overpayment unless they provide written notice to the provider within 365 calendar days after the overpayment was received, identifying the specific error made

Carriers may recover overpayments by withholding or reducing payments on different claims, but must notify the provider in writing within one calendar day, identifying both the original overpaid claim and the claim being reduced

The notice and appeal requirements do not apply when overpayment recovery is based on a reasonable belief of fraud, abuse, or other intentional misconduct

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