OR Prompt Pay Statues

[Guest guest]

Here are the two useful laws and their numbers. There used to be one specifically for Chiropractic, but as I stated the other day our law "Grandfathered" and is no longer active.

It used to be 743A. If you do a search for this, you can see specifics for dentists and acupunturist, but no longer one for chiropractors only.

We believe that failure to release payment may be a violation of ORS § 743.911

(1) Except as provided in this subsection, when a claim under a health benefit plan is submitted to an insurer by a provider on behalf of an enrollee, the insurer shall pay a clean claim or deny the claim not later than 30 days after the date on which the insurer receives the claim. If an insurer requires additional information before payment of a claim, not later than 30 days after the date on which the insurer receives the claim, the insurer shall notify the enrollee and the provider in writing and give the enrollee and the provider an explanation of the additional information needed to process the claim. The insurer shall pay a clean claim or deny the claim not later than 30 days after the date on which the insurer receives the additional information.

Full Text of the Rule is available here : http://www.oregonlaws.org/ors/743.911

Interest based on ORS §743.913

(1) An insurer that fails to pay a claim to a provider within the time lines established in ORS 743.911 shall pay simple interest of 12 percent per annum on the unpaid amount of the claim that is due and owing, accruing from the date after the payment was due until the claim is paid. Interest on any overdue payment for a claim begins to accrue on the 31st day after:

(a) The date on which the insurer received the claim; or

( The date the insurer receives the requested additional information.

Full Text for this rule is available here: http://www.oregonlaws.org/ors/743.913

Hope this helps you all. Respectfully, Franchesca Vermillion, DCVermillion & Bloom, PCBalance & Fitness throughChiropractic Rehabilitation1750 Blankenship Rd Ste 295West Linn, OR 97068503-344-4378www.vermillionbloom.com