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23-63-1802. Time for recoupment.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-63-1802. Time for recoupment.
(a)(1) Except in cases of fraud committed by a healthcare provider, a healthcare insurer may exercise recoupment from a healthcare provider only during the eighteen-month period after the date that the healthcare insurer paid the claim submitted by the healthcare provider.
(2) A healthcare provider may submit a corrected claim for up to six (6) months after recoupment for services that were actually provided but billed in error without the intent to defraud.
(b)(1) A healthcare insurer that exercises recoupment under this section shall give the healthcare provider a written or electronic statement specifying the basis for the recoupment.
(2) At a minimum, the statement shall contain the information required by § 23-63-1804.
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-63-1802
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. A text match is a research starting point; applicability is not established.
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Record provenance
Stable record: arkansas_code:legal_authorities:23-63-1802
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: 3f879338caceca4cd229596a10a55306e25745f36a50b5be0b88e238dbbeaefd
Source location: content.xml paragraph 34522
Stored source content
23-63-1802. Time for recoupment.
(a)(1) Except in cases of fraud committed by a healthcare provider, a healthcare insurer may exercise recoupment from a healthcare provider only during the eighteen-month period after the date that the healthcare insurer paid the claim submitted by the healthcare provider.
(2) A healthcare provider may submit a corrected claim for up to six (6) months after recoupment for services that were actually provided but billed in error without the intent to defraud.
(b)(1) A healthcare insurer that exercises recoupment under this section shall give the healthcare provider a written or electronic statement specifying the basis for the recoupment.
(2) At a minimum, the statement shall contain the information required by § 23-63-1804.
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Arkansas Code — all titles (historical 2020) · legal_authorities
23-63-1804. Recoupments — Required disclosures.
If a health care insurer exercises recoupment, then the health care insurer shall provide the health care provider written documentation that specifies the:
(1) Amount of the recoupment;
(2) Covered person's name to whom the recoupment applies;
(3) Patient identification number;
(4) Date or dates of service;
(5) Service or services on which the recoupment is based;
(6) Pending claims being recouped or future claims that will be recouped; and
(7) Specific reason for the recoupment.
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-63-1804
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. The source passage cites 23-63-1804. This identifies an authority to review, not proof of applicability.