Sec. 3857.
(1) An insurer shall do all of the following:
(a) Accept a notice from a medicare carrier on dually assigned claims submitted by participating physicians and suppliers as a claim for benefits in place of any other claim form otherwise required and make a payment determination on the basis of the information contained in that notice.
(b) Notify the participating physician or supplier and the beneficiary of the payment determination.
(c) Pay the participating physician or supplier directly.
(d) Furnish, at the time of enrollment, each enrollee with a card listing the policy name, number, and a central mailing address to which notices from a medicare carrier may be sent.
(e) Pay user fees for claim notices that are transmitted electronically or otherwise.
(f) Provide to the secretary of health and human services, at least annually, a central mailing address to which all claims may be sent by medicare carriers.
(2) Compliance with the requirements set forth in subsection (1)(a) shall be certified on the medicare supplement insurance experience reporting form.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
Structure Michigan Compiled Laws
Chapter 500 - Insurance Code of 1956
Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)
218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)
Section 500.3801 - Chapter; Definitions.
Section 500.3803 - Applicability of Chapter.
Section 500.3804 - Repealed. 2018, Act 429, Eff. Mar. 20, 2019.
Section 500.3805 - Medicare Supplement Policy; Definitions.
Section 500.3808 - Repealed. 2018, Act 429, Eff. Mar. 20, 2019.
Section 500.3813 - Disability Coverage; Medicare Supplement Buyer's Guide; Applicability of Section.
Section 500.3825 - Preexisting Diseases or Conditions; Waiver Prohibited.
Section 500.3830 - Eligible Person; Requirements.
Section 500.3830a - Termination of Contract or Agreement; Notice to Individual.
Section 500.3833 - Replacement Policy; Waiver of Certain Time Periods.
Section 500.3837 - Repealed. 2002, Act 304, Imd. Eff. May 10, 2002.
Section 500.3843 - Health Insurance; Notice; Contents; Applicability of Subsection (1).
Section 500.3847 - Advertising; Filing Copy With Director.
Section 500.3851 - Aggregate Benefits; Rates, Rating Schedules, and Rate Revisions.
Section 500.3852 - Benchmark Ratio.
Section 500.3853 - Refund or Credit Calculation; Form; Interest; Due Date.
Section 500.3857 - Duties of Insurer; Certification of Compliance With Subsection (1)(a).
Section 500.3859 - Prohibited Conduct; Violation as Misdemeanor; Penalty.