HB 1498 Summary

• Requires health carriers to send electronic acknowledgment of receipt within 48 hours of receiving an electronically filed claim.

• Extends claim processing deadline from 10 working days to 30 processing days, during which carriers must notify claimants whether the claim is "clean" or requires additional information.

• Imposes interest at one percent per month plus a daily penalty equal to one percent of the claim amount if payment is not made by the 45th processing day, with properly denied claims exempted from interest and penalties.

• Requires health carriers to specify all documentation and information needed to process claims as "clean claims" and acknowledge receipt of additional requested information within five calendar days or pay the claim.

• Defines "clean claim" and establishes that third-party contractors and self-insured health plans are subject to these payment requirements, effective January 1, 2011.