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9091 — Puerto Rico Law | CourtGPT
  1. Home/
  2. Laws/
  3. Puerto Rico/
  4. Title Twenty-six - Insurance (§§ 101 — 10377)/
  5. Subtitle 3 - Puerto Rico Health Insurance Code/
  6. Chapter 104/
  7. 9091
Puerto Rico Legal Code

9091

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(a) A health insurance organization or issuer shall make prompt payment of a bill in accordance with the provisions of §§ 301–335 of this title and shall not delay payment for an audit process. Payment on a submitted bill from a third-party shall be based on amounts billed and covered by the patient’s health plan.\n(b) Audit fees shall be paid upon commencement of the claim audit.\n(c) A payment identified in the audit results that is owed to either party by the other, shall be settled by the audit parties within a reasonable period of time not to exceed thirty (30) days after completion of the audit unless the parties agree otherwise.\nHistory —Aug. 29, 2011, No. 194, § 6.110, eff. 180 days after Aug. 29, 2011.