State RegulationsGA specificDifficulty 2/5
A Georgia provider mails a paper claim to an insurer in a situation governed by the surprise billing provisions of the unfair claims article. Failing to pay within which period is an unfair claims settlement practice?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under O.C.G.A. § 33-6-34(15)(B), paper claims must be paid within 30 calendar days; failure to do so is an unfair claims settlement practice in Georgia. The rule pairs with the 15-working-day deadline for electronic claims, giving providers a slower but definite clock for paper submissions enforced by the Insurance Commissioner.
Why the other options are wrong
- A) Fifteen working days is the electronic-claim deadline; paper claims get 30 calendar days under O.C.G.A. § 33-6-34(15)(B).
- B) Ten working days appears nowhere in the unfair claims article; the paper-claim deadline is 30 calendar days under O.C.G.A. § 33-6-34(15)(B).
- C) The paper-claim clock runs in calendar days but for 30, not 15, under O.C.G.A. § 33-6-34(15)(B).
Memory hook
Paper is patient: 30 calendar days; electronic is quick: 15 working days.