AB1455 (California Codedc
of Regulations Sections 1300.71 & 1300.71.38)
* Takes effect for claims services on
or after January 1, 2004. AB1455, California Regulation
on Claims Settlement
Practices and Provider
Dispute Resolution, regulates claim submissions, achknowledgements,
denials and adjustments as well as requires payors to implement
a claims dispute resolution mechanism that is fast, fair
and cost effective.
* Applies to MedPOINT Management clients
commercial HMO enrollment.
Please click the appropriate links below to review formal
instructions for claim and/or provider resolution (PDR)
submissions, as well as the PDR
Request Form. These are in PDF format and you will need
Adobe Acrobat Reader.
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