55 Pa. Code § 1163.501 - Provider right to appeal
(a) The
hospital's right of appeal is under Chapter 1101 (relating to general
provisions).
(b) Hospitals and
practitioners do not have the right to a separate appeal on the same inpatient
case. For purposes of this chapter, inpatient services are considered to be
those services provided by hospital personnel. Practitioner appeals relating to
inpatient services are expected to be resolved through the utilization review
process.
(c) For cases undergoing
the appeal process, payment, including adjustments, will be withheld until the
case is adjudicated.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.