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Current as of March 28, 2024 | Updated by Findlaw Staff
(a) If a health care insurer determines that payment was made for services not covered under the covered person's health insurance coverage, the health care insurer shall give written notice to the health care provider of its intent to exercise recoupment and may:
(1) Request a refund from the health care provider; or
(2) Make a recoupment of the payment from the health care provider in accordance with § 23-63-1804.
(b)(1) Except in the case of fraud committed by the health care provider or as provided in subdivision (b)(2) of this section, subsection (a) of this section shall not apply if a health care provider or other party on its behalf verified from the health care insurer or its agent that an individual was a covered person and if the health care provider in good faith provided services to the individual in reliance on the verification.
(2) A health care insurer has one hundred twenty (120) days from the date of payment to notify the provider of a verification error and the fact that services rendered will not be covered if the error was made in good faith at the time of the verification.
Cite this article: FindLaw.com - Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-63-1803. Persons not covered - last updated March 28, 2024 | https://codes.findlaw.com/ar/title-23-public-utilities-and-regulated-industries/ar-code-sect-23-63-1803/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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