ARTICLE 9.5. Claims Reviewers

Article 9.5 added by Stats. 1992, Ch. 544, Sec. 1.

§§ 1399.55–1399.57 · 3 sections

• § 1399.55 Health care service plans shall, upon rejecting a claim from a health care provider or a patient, and upon their demand, disclose the specific rationale used…
• § 1399.56 Compensation of a person retained by a health care service plan to review claims for health care services shall not be based on either of the following: (a) A…
• § 1399.57 This article does not apply to services or benefits provided pursuant to Medi-Cal, including services or benefits provided under Chapters 7 (commencing with…