Days to Pay: 30§
Authority: 29 CFR Section 2560.503-1
Medicare Part C
Days to Pay: 30∥
Authority: 42 CFR § 422.520
Note: Days to pay assumes electronic submission. Days to pay time frames reflect calendar days unless otherwise noted.
|*||The legal rates for incurring penalties can be no more than 10% per year in Arizona (unless a different rate is contracted for and agreed to in writing) and no more than 12% per year in Virginia.2,3|
|†||Missouri claims exceeding $35,000 result in added penalty of 1% per day for maximum 100 days.|
|‡||Washington time frame applies to 95% of all clean claims submitted.|
|§||ERISA initial time frame is subject to 1-time extension of up to 15 days.|
|∥||Medicare Part C time frame applies to 95% of all clean claims submitted.|
ERISA = Employee Retirement Income Security Act.
References: 1. Data on file. Regeneron Pharmaceuticals, Inc. 44-1201. 2. Rate of interest for loan or indebtedness; interest on judgments; definitions. Arizona state legislature. Accessed March 10, 2023. https://www.azleg.gov/ars/44/01201.htm 3. Code of Virginia. Chapter 3. Interest and usury. Virginia’s Legislative Information System. Accessed March 10, 2023. https://law.lis.virginia.gov/vacodefull/title6.2/chapter3/#:~:text=Except
This material is provided for informational purposes only, is subject to change, and should not be construed as legal or medical advice. Use of this information to challenge or appeal a coverage or reimbursement delay and/or denial by a payer is the responsibility of the provider.