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205.533 Web site of managed care organization.

KY Rev Stat § 205.533 (2019) (N/A)
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205.533 Web site of managed care organization. By January 1, 2019, a managed care organization shall establish an interactive Web site, operated by the managed care organization, that allows providers to file grievances, appeals, and supporting documentation electronically in an encrypted format that complies with federal law and that allows a provider to review the current status of a matter relating to an appeal or a grievance filed concerning a submitted claim. Effective: July 14, 2018 History: Created 2018 Ky. Acts ch. 106, sec. 2, effective July 14, 2018.

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205.532 Definitions for KRS 205.532 to 205.536 -- Contracts for Medicaid services by managed care organizations -- Credentialing verification organization -- Enrollment and contract after receipt of credentialing packet -- Failure to agree on terms and conditions -- Application date -- Credentialing verification by university hospitals -- Electronic verification of licensure information.
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205.534 Toll-free telephone line -- Duties relating to adverse determinations -- In-person meeting -- Reprocessing claims -- Internal appeals -- Timely decisions on authorization and preauthorization requests -- Monthly reports -- Penalties.