California Welfare and Institutions Code 14016.7 – (a) Managed care contracts entered into by the department under …
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(a) Managed care contracts entered into by the department under the act adding this section shall include all of the following:
(1) Contractor requirements concerning eligibility and coverage verification.
Terms Used In California Welfare and Institutions Code 14016.7
- Contract: A legal written agreement that becomes binding when signed.
- department: means the State Department of Health Services. See California Welfare and Institutions Code 14062
(2) Utilization controls.
(3) Claims processing.
(b) The contract requirements shall include all of the following:
(1) Standards for prompt response to provider requests for information.
(2) Twenty-four hour response to emergency service authorization requests.
(3) Use of commonly accepted billing forms.
(Added by Stats. 1991, Ch. 95, Sec. 4. Effective June 30, 1991.)