Resolution 18-210

Submitted by: Richmond Academy of Medicine

WHEREAS,       insurers impose deadlines on when physicians may submit a bill and if a bill is submitted after this date it will not be paid, and

WHEREAS,       on the other hand, pre-authorized procedures patients have had completed can be denied by insurers year later, and

WHEREAS,       there seems to be no statute of limitation on when insurers can do a review and reverse a coverage decision for care the patient/family thought was long since covered, therefore be it

RESOLVED,     the Medical Society of Virginia support the implementation of a mandatory deadline of no less than twelve months from the date of service for physicians to submit claims; and further be it 

RESOLVED,     the Medical Society of Virginia support requiring insurers to add a minimum of 30 days to the submission deadline every time they kick a claim back to a physician for any reason, and be it further

RESOLVED,     that the Medical Society of Virginia support enforcement of coverage for pre-authorized services by insurance companies and prevents later reversal of already granted pre-authorization. 

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