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DIVISION 2. LICENSING PROVISIONS 1200-1796.70›CHAPTER 2.2. Health Care Service Plans 1340-1399.864›ARTICLE 9.5. Claims Reviewers 1399.55-1399.57

§ 1399.56

California Health and Safety Code · 2020-11 edition · updated 2026-10-04 · California

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 the following:

(a) A percentage of the amount by which a claim is reduced for payment.

(b) The number of claims or the cost of services for which the person has denied authorization or payment.

(Amended by Stats. 1995, Ch. 787, Sec. 2. Effective January 1, 1996.)

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California Health and Safety Code

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