Earlier editions: 2020-112018-11
DIVISION 2. LICENSING PROVISIONS 1200-1796.88›CHAPTER 2.2. Health Care Service Plans 1340-1399.874›ARTICLE 9.5. Claims Reviewers 1399.55-1399.57
§ 1399.55
California Health and Safety Code · 2026-10 edition · updated 2026-10-04 · California
Health care service plans shall, upon rejecting a claim from a health care provider or a patient, and upon their demand, disclose the specific rationale used in determining why the claim was rejected. Nothing in this section is intended to expand or restrict the ability of a health care provider or a patient from having health care coverage approved in advance of services.
(Added by Stats. 1992, Ch. 544, Sec. 1. Effective January 1, 1993.)
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