11 NCAC 21 .0108             CLAIMS ADMINISTRATION

(a)  Each TPA's claims administration service shall be supported by a set of written policies, procedures, and performance standards related to timeliness in payment of claims and its financial operations.

(b)  Each TPA shall develop and implement a claims administration internal audit and a quality assurance program to monitor and improve claims processing services.

History Note:        Authority G.S. 58-2-40; 58-56-26; 58-56-31; 58-56-51;

Eff. June 1, 1996;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 16, 2014.