FMA advocacy leads to insurer audits

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    As a result of information presented by the FMA staff, the Florida Office of Insurance Regulation (OIR) is launching an industry-wide audit of all health insurers and HMOs operating in Florida. This audit is in addition to the targeted investigations that OIR has already initiated, based on information provided by the FMA, related to complaints of retroactive denials. The audits will be looking for:

    • Systemic claims denials
    • Violations of Florida's prompt pay laws
    • Retroactive denials

    OIR has indicated that it will be happy to meet with FMA representatives to discuss specific issues they have had with insurers. Please contact FMA Director of Payment Advocacy Monte Stevens at (800) 762-0233 or (850) 224-6496 if you have any issues that you would like to bring to OIR's attention.

    This is another example of how FMA membership delivers on the promise of Helping Physicians Practice Medicine.