120.932 Insurance Simplification of Explanation of Benefits (EOBs) The Medical Society of the State of New York will seek regulation or legislation that would require all claims from a health care provider relating to a single encounter be reported together on the same EOB, rather than across multiple EOBs in order to
120.931 NYS Private Payer Medical Necessity Guidelines MSSNY will support legislation and/or regulation which prohibit insurance companies from using proprietary guidelines to deny pre-authorization and/or payment. (HOD 2016-251)
120.930 Centralized Insurance Registry The Medical Society of the State of New York (MSSNY) working with the New York State Department of Health — Office of Health Insurance Programs will seek establishment of a centralized system of insurance eligibility accessible to all providers. (HOD 2016-254)
120.929 Improving Medical Insurance Customer Service The Medical Society of the State of New York (MSSNY) will seek regulation or legislation which ensures that all coverage information be made available to health insurance customer service agents to review with patients during phone conversations. MSSNY will seek regulation or legislation which ensures
120.928 Transfer of Insureds to Other Carriers without Proper Notification The Medical Society of the State of New York (MSSNY) will work with the appropriate state agencies to enact regulation banning the transfer of insureds or contract term changes without appropriate and easy to understand written notice of at least 90
120.927 Deleting State or Federally-Mandated Coverage The Medical Society of the State of New York will seek federal regulation or legislation that prohibits self-insured health insurance companies from deleting coverage mandated by government. (HOD 2016-259)
120.926 Private Insurers and Managed Care Organizations Pre–Authorization/Pre–Certification Protocols The Medical Society of the State of New York (MSSNY) will seek legislation or regulation applying to all insurers which will: Require insurance companies to provide clear instructions in a timely manner about the procedure for obtaining a prior authorization; Require
120.925 Peer-to-Peer Reviews by Insurers The Medical Society of the State of New York will seek legislation to change peer to peer review by insurers to include evidence-based criteria publicly available and to be conducted by a physician of the same specialty and responded to the physician practice on a timely basis via fax or
120.924 New York State Insurance Fund Unfair Rule Changes The Medical Society of the State of New York will work with all relevant agencies, including the Workers Compensation Board, to force the New York State Insurance Fund to return to the policy of providing physician offices with both the status
120.923 Prompt Response to Physician’s Request for Patient Care Services Authorization MSSNY will seek legislation and/or regulation requiring all insurance plans to respond in one business day to requests for services for the patient and if such response is not in the affirmative, then the response must include an option for
