Relevant Statute
C.R.S. 10-16-704 (2009)
Time Period
12 Months
Limits for Recovery on Overpaid Claims
Adjustments to claims by the carrier shall be made within the time period set out in contract between the provider and the carrier. The time period shall be the same for the provider and the carrier and shall not exceed 12 months after the date of the original explanation of benefits. If no contract exists then adjustments to claims shall be made 12 months after the date of the original explanation of benefits.
Additional Details
Adjustments to claims related to coordination of benefits with federally funded health benefit plans, including medicare and medicaid, shall be made within thirty-six (36) months after the date of service.
Exemptions
Does not apply in cases of fraud
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