September 28, 2017
Area(s) of Interest: Professional Development & Education
The California Medical Association (CMA) recently hosted a free members-only webinar on the different options for challenging AB 72 interim payments. The webinar is now available for on-demand viewing in the CMA resource library.
Under AB 72, which took effect July 1, 2017, plans and insurers are required to make “interim payments” to non-contracted physicians for covered, non-emergent services performed at in-network health facilities. The interim payment is the greater of either the plan/insurer’s average contracted rate or 125 percent of the Medicare rate for the same or similar services in the general geographic region in which services were rendered. However, the new law does include mechanisms for physicians to challenge the interim payment.
CMA’s on-demand webinar includes an overview of the dispute options, details on how the AB 72 “independent dispute resolution process” will work and CMA resources available to assist physician members.
For more information, visit the Out-of-Network Billing page or call CMA’s Reimbursement Helpline at (888) 401-5911.