Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 60 - Regulation 74-Payment of Health Coverage Claims
Section XIII-6015 - Limitations on Claim Filing and Audits

Universal Citation: LA Admin Code XIII-6015

Current through Register Vol. 50, No. 9, September 20, 2024

A. Health insurance issuers that limit the period of time that a claim may be filed for payment of benefits shall have the same limited period of time following payment of such claims to perform any review or audit for purposes of reconsidering the validity of such claims. For example, where a health insurance issuer limits the period for filing a claim for benefits to 12 months, then the health insurance issuer shall be limited to 12 months from the date of payment to perform any review or audit of the claim.

AUTHORITY NOTE: Promulgated in accordance with R.S. 22:3, 22:250.35, to implement and enforce the following provisions R.S. 22:230.4(A)(4), Part VI-D of Chapter 1 of the Louisiana Revised Statutes of 1950, and R.S. 40:2203.1.

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