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Your Must Know Guide to Getting Health Insurance to Pay

Wednesday, 4th February 2009

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This question was submitted by Michelle Hunt of Back To Health Chiropractic West Jordan, Utah.

The answer pertains to Utah law.  Other states often have similar provisions.  Check your state’s laws or call your state’s insurance commission or equivalent to find out your rights in your state. A list of the addresses and phone numbers for the insurance commissions in all 50 states follows this article.

WHEN HEALTH INSURANCE IS NOT PAYING YOUR BILLS

Q Is there a law requiring health insurance to pay within a specific period of time

A.  Yes, in Utah an adjuster has 30 days to  pay or deny a health insurance claim.  If she can’t pay or deny the claim with the information you gave her she may ask for more information.  She may also take advantage of a 30 day extension for claims that need investigation.

If the adjuster  uses the 30 day extension for investigation she  must inform the doctor  before the end of the initial 30 days 1)  the nature of the investigation,   2) the time line  for investigation and 3) the anticipated completion date.

In Utah, the insurer can get more time for investigation only by making a written request to the Insurance Commissioner.

You can charge a late fee when the adjuster does not comply.  It is the unpaid amount times the number of days times 1/10 of 1%.  For example, the unpaid bill of $500 is not paid for 60 days and so is paid 30 days late.   Take $500 and multiply by 30 and multiply that by 1/10 of 1% ($500 x 30 x .001 = $15).

You may refer to this law in your letter or phone call to the adjuster: Utah Code Annotated Section 31A-26-301.6.  It is entitled the Health Care Provider Claims Practices Act.

Alabama
Alabama Department of Insurance
State Insurance Commissioners Office
135 South Union Street
Montgomery, AL 36130
Main Phone: 1-334-269-3550
Fax: 1-334-241-4192

Alaska
State Insurance Commissioners Office
Alaska Department of Commerce & Economics
P.O. Box 110805
Juneau, AK 99811-0805
Main Phone: 1-907-465-2515
Fax: 1-907-465-3422

Arizona
Arizona Department of Insurance
State Insurance Commissioners Office
2910 North 44th Street
Suite 210
Phoenix, AZ 85018-7256
Main Phone: 1-602-912-8400
Fax: 1-602-912-8452

Arkansas
State Insurance Commissioners Office
2100 West 3rd Street
Little Rock, AR 72201-1904
Main Phone: 1-501-371-2600
Fax: 1-501-371-2618

California
California Department of Insurance
State Insurance Commissioners Office
300 Capital Mall
Suite 1500
Sacramento, CA 95814
Main Phone: 1-916-492-3500
Fax: 1-916-445-4280

Department of Managed Health Care
California HMO Help Center
980 Ninth Street, Suite 500
Sacramento, CA 95814-2725
Main Phone: 1-888-HMO-2219
Fax Number: 1-916-229-0465
Email: helpline@dmhc.ca.gov

Colorado
Colorado Department of Insurance
State Insurance Commissioners Office
Colorado Division of Insurance
1560 Broadway, Suite 850
Denver, CO 80202
Main Phone: 1-303-894-7499
Alternate Phone: 1-800-930-3745
Fax: 1-303-894-7455

Connecticut
Connecticut Department of Insurance
State Insurance Commissioners Office
P.O. Box 816
Hartford, CT 06142-0816
Main Phone: 1-860-297-3802
Fax: 1-860-566-7410

Delaware
State Insurance Commissioners Office
Rodney Building
841 Silver Lake Blvd.
P.O. Box 7007
Dover, DE 19903
Main Phone: 1 302-739-4251
Fax: 1-302-739-5280

District of Columbia
District of Columbia Department of Insurance
Insurance Administration
441 Fourth Street, NW
8th Floor North
Washington, DC 20001
Main Phone: 1-202-727-8000 ext. 3018
Fax: 1-202-535-1196

Florida
Florida Department of Insurance
State Insurance Commissioners Office
State Capital
Plaza Level Eleven
Tallahassee, FL 32399-0300
Main Phone: 1- 800 342 2762
Fax: 1-850-488-6581

Georgia
State Insurance Commissioners Office
2 Martin Luther King, Jr. Dr.
Floyd Memorial Bldg.
Atlanta, GA 30334
Main Phone: 1-404-656-2056
Fax: 1-404-657-8542

Hawaii
Hawaii Department of Insurance
State Insurance Commissioners Office
Department of Commerce and Consumer Affairs
250 S. King Street, 5th Floor
Honolulu, HI 96813
Main Phone: 1-808-586-2790
Fax: 1-808-586-2806

Idaho
Idaho Department of Insurance
PO Box 83720
Boise, ID 83720-0043
Main Phone: 1-800-721-3272

Illinois
Illinois Department of Insurance
State Insurance Commissioners Office
320 West Washington Street
4th Floor
Springfield, IL 62767
Main Phone: 1-217 785-4515
Fax: 1-217-782-5020

Indiana
Indiana Department of Insurance
State Insurance Commissioners Office
311 West Washington St
Suite 300
Indianapolis, IN 46204-2787
Main Phone: 1-317-232-2385
Fax: 1-317-232-5251

Iowa
Iowa Division of Insurance
State Insurance Commissioners Office
Lucas State Office Building
6th Floor
Des Moines, IA 50319
Main Phone: 1-515-281-5705
Fax: 1-515-281-3059

Kansas
Kansas Department of Insurance
State Insurance Commissioners Office
420 SW 9th St
Topeka, KS 66612-1678
Main Phone: 1-785-296-7801
Fax: 1-785-296-2283

Kentucky
State Insurance Commissioners Office
PO Box 517
215 West Main St
Frankfort, KY 40602-0517
Main Phone: 1-502-564-6027
Fax: 1-502-564-6090

Louisiana
Louisiana Department of Insurance
State Insurance Commissioners Office
Louisiana Department of Insurance
950 North 5th St
Baton Rouge, LA 70804-9214
Main Phone: 1-225-343-4834

Maine
State Insurance Commissioners Office
Dept. of Professional & Financing Regulations
State Office Building
Station 34
Augusta, ME 04333-0034
Main Phone: 1-207-624-8475
Fax: 1-207-624-8599

Maryland
Maryland Bureau of Insurance
State Insurance Commissioners Office
501 St. Paul Place
Stanbalt Building, 7th Floor South
Baltimore, MD 21202-2272
Main Phone: 1-410-468-2000

Massachusetts
Massachusetts Department of Insurance
State Insurance Commissioners Office
470 Atlantic Ave
Boston, MA 02210-2223
Main Phone: 1-617-521-7794
Fax: 1-617-521-7772

Michigan
State Insurance Commissioners Office
Michigan Insurance Bureau, Department of Commerce
611 W Ottawa St
2nd Floor, North
Lansing, MI 48933-1020
Main Phone: 1-517-373-9273
Fax: 1-517-373-9273

Minnesota
Minnesota Department of Commerce
State Insurance Commissioners Office
133 East 7th St
St. Paul, MN 55101
Main Phone: 1-651-296-6025
Fax: 1-651-282-2568

Mississippi
Mississippi Department of Insurance
State Insurance Commissioners Office
1804 Walter Sillers Building
Jackson, MS 39205
Main Phone: 1-601-359-3569
Fax: 1-601-359-2474

Missouri
Missouri Department of Insurance
State Insurance Commissioners Office
301 West High St 6 North
Jefferson City, MO 65102-0690
Main Phone: 1-573-751-4126
Fax: 1-573-751-1165

Montana
State Insurance Commissioners Office
126 North Sanders
270 Mitchell Building
Helena, MT 59601
Main Phone: 1-406-444-2040

Nebraska
State Insurance Commissioners Office
Terminal Building
941 ‘O’ St
Lincoln, NE 68509-8920
Main Phone: 1-402-471-2201
Fax: 1-402-471-4610

Nevada
State Insurance Commissioners Office
1665 Hot Springs Rd
Carson City, NV 89710
Main Phone: 1-775-687-4270
Fax: 1-775-687-3937

New Hampshire
State Insurance Commissioners Office
56 Old Suncook Rd
Concord, NH 03301-7317
Main Phone: 1-800-852-3416 -or- 1-603-271-2261
Fax: 1-603-271-1406

New Jersey
New Jersey Department of Insurance
State Insurance Commissioners Office
20 West State St
CN325
Trenton, NJ 08625
Main Phone: 1-609-292-7272
Fax: 1-609-984-5273

New Mexico
New Mexico Department of Insurance
State Insurance Commissioners Office
PO Box Drawer 1269
Santa Fe, NM 87504-1269
Main Phone: 1-505-827-4601
Fax: 1-505-827-4734

New York
State Insurance Commissioners Office
160 West Broadway
New York, NY 10013
Main Phone: 1-212-480-6400

North Carolina
North Carolina Department of Insurance
State Insurance Commissioners Office
4140 Dobbs Building
PO Box 26387
Raleigh, NC 27611
Main Phone: 1-919-733-7349
Fax: 1-919-733-0085

North Dakota
State Insurance Commissioners Office
600 E. Blvd
Bismarck, ND 58505-0320
Main Phone: 1-701-328-2440
Fax: 1-701-328-4880

Ohio
State Insurance Commissioners Office
Ohio Department of Commerce & Economics
2100 Stella Court
Columbus, OH 43215
Main Phone: 1-614-644-2658
Fax: 1-614-644-3744

Oklahoma
Oklahoma Department of Insurance
State Insurance Commissioners Office
3814 N Santa Fe
Oklahoma City, OK 73118
Main Phone: 1-405-521-2686
Fax: 1-405-521-6635

Oregon
State Insurance Commissioners Office
Dept. of Consumer & Business Services
350 Winter St NE
Room 200
Salem, OR 97310-0700
Main Phone: 503-947-7980

Pennsylvania
State Insurance Commissioners Office
Pennsylvania Department of Insurance
1326 Strawberry Square
13th Floor
Harrisburg, PA 17120
Main Phone: 1-717-787-7000
Fax: 1-717-772-1969

Puerto Rico
State Insurance Commissioners Office
Puerto Rico Department of Insurance
Cobian’s Plaza Building
1607 Ponce de Leon Ave
Santurce, PR 00909
Main Phone: 1-787-722-8686

Rhode Island
State Insurance Commissioners Office
Department of Business Regulation
233 Richmond St
Suite 233
Providence, RI 02903-4233
Main Phone: 1-401-456-9100
Fax: 1-401-456-9284

South Carolina
State Insurance Commissioners Office
South Carolina Department of Insurance
1612 Marion St
PO Box 100105
Columbia, SC 29202-3105
Main Phone: 1-803-737-6212
Fax: 1-803-737-6231

South Dakota
State Insurance Commissioners Office
Dept. of Commerce & Regulation
500 E. Capitol
Pierre, SD 57501
Main Phone: 1-605-773-3563
Fax: 1-605-773-5369

Tennessee
State Insurance Commissioners Office
Department of Commerce and Insurance
500 James Robertson Parkway
4th Floor
Nashville, TN 37243-0574
Main Phone: 1-800-342-4029 (toll-free)
Alternate Phone: 1-615-741-2218

Texas
State Insurance Commissioners Office
Texas Department of Insurance
333 Guadeloupe St
PO Box 149104
Austin, TX 78714-9104
Main Phone: 1-512-463-6464
Fax: 1-512-475-2005

Utah
State Insurance Commissioners Office
Utah Department of Insurance
3110 State Office Building
Salt Lake City, UT 84114-1201
Main Phone: 1-801-538-3800
Fax: 1-801-538-3829

Vermont
State Insurance Commissioners Office
Vermont Division of Insurance
Department of Banking, Insurance & Securities
89 Main St, Drawer 20
Montpelier, VT 05620-3101
Main Phone: 1-802-828-3301
Fax: 1-802-828-3306

Virginia
State Insurance Commissioners Office
Virginia Bureau of Insurance
State Corporation
1300 East Main Str
Richmond, VA 23219
Main Phone: 1-804-371-9694
Fax: 1-804-371-9873

Washington
State Insurance Commissioners Office
Washington Office of the Insurance
14th Ave. & Water Streets
PO Box 40255
Olympia, WA 40255
Main Phone: 1-360-753-7301
Fax: 1-360-586-3535

West Virginia
West Virginia Department of Insurance
State Insurance Commissioners Office
PO Box 50540
Charleston, WV 25305-0540
Main Phone: 1-800-642-9004
Alternate Phone: 1-304-558-3386
Fax: 1-304-558-4965

Wisconsin
State Insurance Commissioners Office
Office of the Commissioner of Insurance
State of Wisconsin
121 E Wilson
Madison, WI 53707-7873
Main Phone: 1-608-266-0102

Wyoming
State Insurance Commissioners Office
Wyoming Department of Insurance
Herschier Building
122 West 25th St, 3rd East
Cheyenne, WY 82002-0440
Main Phone: 1-307-777-7401
Fax: 1-307-777-5895

 
 
 

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