New York State
Insurance Department
 

DEPARTMENT ACTIVATES A SPECIAL HOTLINE NUMBER
TO ENSURE THAT HMOS PROMPTLY PAY DOCTORS & HOSPITALS


New York, January 26, 1998 

Superintendent of Insurance Neil D. Levin today announced that the Insurance Department has activated a special toll-free hotline phone number for doctors and other health care providers to call when they do not receive prompt payment of claims from HMOs and insurance companies, as now required under a new State law. 

Governor Pataki signed legislation last September that requires HMOs and insurers to pay claims and bills within 45 days of receipt or face fines of up to $500 per day for each claim not paid after the 45 day limit. The law became effective January 22. 

"Governor Pataki’s legislation empowers the Department to take strong action against companies that fail to pay claims within 45 days or fail to respond to Department inquiries about delays," said Superintendent Levin. "We will take all actions necessary to ensure that HMOs and insurance companies are responsive to their members as well as medical providers. I encourage doctors and other medical providers to call this hotline so we can help ensure that HMOs respond quickly to medical providers." 

The Provider Hotline number is 1-800-358-9260. 

The toll-free hotline will make it easier for providers to register their complaints and easier for the Department to monitor those companies who are violating the law so that the State can aggressively pursue HMOs and insurers that do not pay in a timely manner. 

HMOs and insurance companies must pay claims within 45 day except in cases where the obligation to make payment is not clear or where fraud is suspected. In cases where the obligation to pay is not clear, the HMO or insurer must pay the undisputed portion of the claim within the 45 day time period.


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