Relevant Statute
§20-3102
Time Period
12 Months
Limits for Recovery on Overpaid Claims
A health care insurer shall not adjust or request adjustment of a payment or denial of claim more than one year after the date health care insurer has paid the claim. If a provider and insurer agree through contract about adjustment then even they have same length of time to request adjustment of a claim. Once claim is adjusted an insurer or provider shall owe no interest on the overpayment or underpayment resulting from the adjustment as long as the adjustment or recoupment taken within the period of 30 days of the date of claim
adjustment.
Additional Details
None
Exemptions
Does not apply in cases of fraud
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