Enforcing prompt-payment regulations: the Texas approach.
To ensure that insurance carriers pay providers in a timely manner, Texas has adopted strict payment regulations. Enforcement of the regulations has led to restitution payments for many providers. However, issues such as clean claims, underpayment, discrepancies in payment dates, and self-funded claims continue to present challenges.
McCoy
Jim E
JE
Ernst & Young, LLP, Dallas, Texas, USA. jim.mccoy@ey.com
Han
Michael C
MC
Malloy
Michael S
MS
D017598:Efficiency, Organizational; D019983:Guideline Adherence; D007344:Insurance Claim Reporting / Q000331:legislation & jurisprudence*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D013781:Texas; D013997:Time Factors