Claims Processing

Section 755 Section 755.50  Claims Processing a)         In order to provide for the accurate and timely processing of claims, the Department will secure the services of a professional administrator.  The Administrator will be selected based on criteria elaborated in Exhibit A of this Part including: 1)         qualifications; 2)         ability to perform vendor responsibilities; 3)         technical capabilities; 4)         certifications; and 5)         cost. b)         All claims and supporting documentation will be verified by the Administrator.  The Administrator may request from employees any additional documentation the Administrator deems necessary to process and verify claims.  The Department will determine the validity of claims based upon recommendations from the Administrator.