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PDFWAC 284-51-210

Coordination procedures.

Issuers must use the following claims administration practices to expedite claim payments where coordination of benefits is involved:
(1) Claim personnel must participate in continuing education programs.
(2) All requests for information must be handled in an accurate and prompt manner by the inquiring issuer and the responding issuer, including the disclosure of the amounts allowed and paid or to be paid by the primary plan for each claim.
(3) Claim personnel of all issuers, whether primary or secondary, must make every reasonable effort, including use of the telephone or email, to speed up exchange of coordination of benefits information. Delay of payment for lack of complete coordination of benefits information does not constitute a reasonable effort and compliance with WAC 284-51-215 is required.
[Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200. WSR 07-13-008 (Matter No. R 2005-07), ยง 284-51-210, filed 6/8/07, effective 7/9/07.]
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