Pennsylvania Promt Pay Law

This regulation is directly from the Pennsylvania State Department of Insurance and is specific for manage care/indemnity plans
　

If utilized properly, you will ensure your collections without having to beg and plead

from the desk of:

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

The carriers have 45 days to pay or deny after receipt of a clean claim. Anything beyond that will result in a default of the payment of your claim and mandate a 10% penalty to be paid, by regulation. A telephone call will fall on deft ears, therefore create a paper trail with a demand for payment.

The Law:

§ 991.2166 (1998)

Language for your complaint:

Dear Claims Examiner:

The services rendered were billed within the Pennsylvania Insurance guidelines. It has now been beyond 45 working days allowed by Pennsylvania Prompt Pay Law, Section § 991.2166 (1998)

Since you have violated this regulation we can submit this entire claim for summary judgment or arbitration through our legal counsel.

　We would like to resolve this issue without using legal counsel. If we do go to court, It will cost you both the amount of the claim and attorney fees with 10% interest annually as mandated by regulation Section § 991.2166 (1998)

　We request payment within 3 weeks of the date of this letter for the resubmitted bill(s) as prescribed by law. By doing so we will waive the interest due us as described in the regulations previously cited. If we do not receive payment, we will be forced to litigate this matter and also file a complaint with the Pennsylvania Department of Insurance.

Pennsylvania Insurance Department
1326 Strawberry Square
Harrisburg, Pennsylvania 17120

717-783-0442

Philadelphia Office
801 Market Street, Room 6062
Philadelphia, Pennsylvania 19107

215-560-2630