500.3857 Duties of insurer; certification of compliance with subsection (1)(a).
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500.3857 Duties of insurer; certification of compliance with subsection (1)(a).
Sec. 3857.
(1)An insurer shall do all of the following:
(a)Accept a notice from a medicare carrier on dually assigned claims submitted by participating physicians and suppliers as a claim for benefits in place of any other claim form otherwise required and make a payment determination on the basis of the information contained in that notice.
(b)Notify the participating physician or supplier and the beneficiary of the payment determination.
(c)Pay the participating physician or supplier directly.
(d)Furnish, at the time of enrollment, each enrollee with a card listing the policy name, number, and a central mailing address to which notices from a medicare carrier may be sent.
(e)Pay user fees for claim notices that are transmitted electronically or otherwise.
(f)Provide to the secretary of health and human services, at least annually, a central mailing address to which all claims may be sent by medicare carriers.
(2)Compliance with the requirements set forth in subsection (1)(a) shall be certified on the medicare supplement insurance experience reporting form.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name: Act 218