New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 22 - HEALTH BENEFIT PLANS
Subchapter 1 - PROMPT PAYMENT OF CLAIMS
- Section 11:22-1.1 - Purpose and scope
- Section 11:22-1.2 - Definitions
- Section 11:22-1.3 - Acknowledgement of receipt of claims
- Section 11:22-1.4 - Claim submission requirements
- Section 11:22-1.5 - Prompt payment of claims
- Section 11:22-1.6 - Denied and disputed claims
- Section 11:22-1.7 - Prompt payment of capitation payments
- Section 11:22-1.8 - Reimbursement of overpaid claims
- Section 11:22-1.9 - Reimbursement of underpaid claims
- Section 11:22-1.10 - Internal appeals-health carriers
- Section 11:22-1.11 - Internal appeals-dental plan organizations and dental service corporations
- Section 11:22-1.12 - External appeals-alternative payment dispute resolution-dental plan organizations and dental service corporations
- Section 11:22-1.13 - External appeals-health carriers-arbitration
- Section 11:22-1.14 - Reporting requirements
- Section 11:22-1.15 - Remediation/penalty
- Section 11:22-1.16 - Explanation of benefits
- Appendix A
- Appendix A-1
- Appendix B
- Appendix B-1
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