Effective January 1, 2004, contracted providers and their claims processing organizations are required to be in full compliance with California regulations promulgated under AB 1455/SB 1177…2000). These regulations set standards for claims processing and dispute resolution mechanisms to facilitate the prompt and efficient submission, processing and payment of claims and fast, fair and cost-effective dispute resolution.
Serra Community Medical Clinic began preparing to meet these new standards months in advance. Our claims, provider network and contracts, reporting, and provider appeals functions have been intensely scrutinized and where necessary, modified and enhanced to meet the new regulatory standards. Using this website as a mechanism for communicating with providers, Serra Community Medical Clinic will keep providers who serve our patients more fully informed of the group’s claims, settlement practices, and policies.