California Health and Safety Code ARTICLE 9.5 - Claims Reviewers

• Section 1399.55.
  Health care service plans shall, upon rejecting a claim from a health care provider or a patient, and upon their demand, disclose the specific rationale...
• Section 1399.56.
  Compensation of a person retained by a health care service plan to review claims for health care services shall not be based on either of...
• Section 1399.57.
  This article does not apply to services or benefits provided pursuant to Medi-Cal, including services or benefits provided under Chapters 7 (commencing with Section 14000)...

Last modified: October 22, 2018