The health plan failed to explain why it needed additional information before paying claims
May 25, 2011 -- Providence Health Plan was fined $20,000 by the Department of Consumer and Business Services for failing to explain why it needed additional information before paying claims.
From April 2008 through January 2011, Providence received 9,814 claims. Insurers are required to pay or deny a claim 30 days after they receive the necessary information.
“When we became aware of the problem (the need to be more specific in our requests for additional information to pay claims), we took steps to correct it,” said Carrie Smith, director of regulatory compliance and government affairs for Providence. “It’s important to note that all claims were paid accurately."
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