265.889 Claims Denial Although Accurately Coded:
MSSNY will seek legislation that (1) would mandate the health care provider discuss denials based on policy, utilization or medical necessity with a physician of the insurance company rather than a non-physician representative and (2) the discussion between the health care provider and the Medical Director of the insurance company take place within a reasonable length of time after the request for such is made. (HOD 2009-265; Reaffirmed HOD 2019)
