What Should I Do If I Have A Problem Getting Paid By A Payor?
Recent amendments to the Knox-Keene Act have required each Health Care Service Plan to provide “a fast, fair and cost-effective dispute resolution mechanism under which providers may submit disputes to the plan”. You should always first try to resolve your concern directly with the Health Care Service Plan, through its dispute resolution mechanism. If you disagree with the payor’s dispute resolution response, you may submit a complaint through the Department’s website.
The Knox-Keene Act and its implementing Regulations require each Health Care Service Plan to provide “a fast, fair and cost-effective dispute resolution mechanism under which providers may submit disputes to the plan”. You should always first try to resolve your concern directly with the Health Care Service Plan, through its dispute resolution mechanism. If you disagree with the payor’s dispute resolution response, you may submit a complaint through the Department’s website.
