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24.29.1426    HOSPITAL SERVICE RULES

(1) Any overall rate change adopted by a hospital shall be reported to the department on a department-approved form before the effective date of the rate change. The department may in its discretion conduct audits of any hospital's financial records to determine proper reporting of rate change filings.

(2) Charges billed by a hospital are not subject to reduction under the Montana relative value fee schedule, except that hospital professional fees may be paid according to either the fee schedule or the applicable hospital rates, but not both. In the event that the department adopts a relative value fee schedule for out-patient services, this rule will be amended.

(3) Insurers shall make timely payments of hospital bills. In cases where there is no dispute over liability the insurer shall, within 30 days of receipt of a hospital's charges, either pay the charges according to the rates established by these rules, or notify the hospital that additional information is requested, and specify that information. The insurer shall then pay the charges within 30 days of receipt of the requested information.

History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 1998 MAR p. 759, Eff. 4/1/98.

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