The following statements are about some of the issues surrounding the contractual responsibilities of health...

Typically, health plans are required to pay completed claims within 10 days of submission.

Health plans typically are prohibited from examining the financial soundness of a self-funded employer plan that relies on the health plan to pay providers for services received by the plan’s members.

Patient delivery is one of the most significant factors that health plans consider when determining whether provider services should be reimbursed on a capitated or fee-for-service (FFS) basis.

Health plans require all providers to agree to an exclusive provider contract.