Section 2908.90  Medical Documentation Necessary for Billing Adjudication

a)         Medical documentation includes all medical reports and records permitted or required in accordance with the Act.

b)         Requests for medical reports shall be accompanied by releases from the patient.

c)         Any request by the payer for additional documentation to process a medical bill shall conform to the requirements of Section 2908.70(c).

d)         It is the obligation of an insurer or employer to furnish its agents with any documentation necessary for the resolution of a medical bill.

e)         Payers shall take reasonable steps to ensure that health care providers, health care facilities, third-party biller/assignees, and claims administrators and their agents comply with all applicable federal and State rules related to privacy, confidentiality and security.