Claims

AB1455 Claims Settlement

Practices & Dispute Resolution Mechanism

As required by Assembly Bill 1455, the California Department of Managed Health Care has set forth regulations establishing certain claim settlement practices and the process for resolving claims disputes for managed care products regulated by the Department of Managed Health Care. This information notice is intended to inform you of your rights, responsibilities, and related procedures as they relate to claim settlement practices and claim disputes for commercial HMO, POS, and, where applicable, PPO products where Palo Alto Medical Foundation is delegated to perform claims payment and provider dispute resolution processes.

AB1455 Claims Settlement Practices & Dispute Resolution Mechanism