284-170-310  <<  284-170-320 >>   284-170-330

WAC 284-170-320

Issuer recordkeepingProvider networks.

(1) An issuer must make available to the commissioner upon request its records, contracts, and agreements related to its provider networks.
(a) Records to support proof of good faith contracting efforts must be retained for seven years.
(b) Signed contracts, reimbursement agreements, and associated accounting records must be retained for ten years after the contract is terminated.
(2) Beginning January 1, 2016, an issuer must be able to provide to the commissioner upon request the following information for a time period specified by the commissioner. These records must be retained for a period of ten years:
(a) The number of requests submitted for prior authorization for services by all providers and facilities;
(b) The total number of such requests processed; and
(c) The total number of such requests denied.
[Statutory Authority: RCW 48.02.060. WSR 16-07-144 (Matter No. R 2016-01), recodified as § 284-170-320, filed 3/23/16, effective 4/23/16. WSR 16-01-074, recodified as § 284-43-9979, filed 12/14/15, effective 12/14/15. Statutory Authority: RCW 48.02.060, 48.18.120, 48.20.450, 48.20.460, 48.43.055, 48.43.505, 48.43.510, 48.43.515, 48.43.530, 48.43.535, 48.43.730, 48.44.020, 48.44.050, 48.44.080, 48.46.030, 48.46.200. WSR 16-01-074 (Matter No. R 2014-08), § 284-43-225, filed 12/14/15, effective 1/14/16.]
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