{"data":{"id":"us-ky/krs-304.17a-714","jurisdiction":"us-ky","citation":"KRS 304.17A-714","heading":"Collection of claim overpayments -- Dispute resolution.","body":"(1) Except for overpayments which are a result of an error in the payment rate or\nmethod, an insurer that determines that a provider was overpaid shall, within\ntwenty-four (24) months from the date that the insurer paid the claim, provide\nwritten or electronic  notice to the provider of the amount of the overpayment, the\ncovered person's name, patient identification number, date of service to which the\noverpayment applies, insurer reference number for the claim, and the basis for\ndetermining that an overpayment exists. Electronic notice includes e -mail or\nfacsimile where the provider agreed in advance in writing to receive such notices.\nThe insurer shall either:\n(a) Request a refund from the provider; or\n(b) Indicate on the notice that, within thirty (30) calenda r days from the postmark\ndate or electronic delivery date of the insurer's notice, if the insurer does not\nreceive a notice of provider dispute in accordance with subsection (2) of this\nsection, the amount of the overpayment will be recouped from future\npayments.\n(2) If a provider disagrees with the amount of the overpayment, the provider shall\nwithin thirty (30) calendar days from the postmark date or the electronic delivery\ndate of the insurer's written notice dispute the amount of the overpayment by\nsubmitting additional information to the insurer.\n(3) If a provider files a dispute in accordance with subsection (2) of this section, no\nrecoupment shall be made until the dispute is resolved. If a provider does not\ndispute the amount of the overpayment and does not provide a refund as required in\nsubsection (2) of this section, the insurer may recoup the amount due from future\npayments.\n(4) All disputes submitted by providers pursuant to subsection (2) of this section shall\nbe processed in accordance and comp leted within thirty (30) days with the insurer's\nprovider appeals process.\n(5) An insurer may recover an overpayment resulting from an error in the payment rate\nor method by requesting a refund from the provider or making a recoupment of the\noverpayment from the provider, subject to the provisions of subsection (6) of this\nsection. A provider may dispute such recoupment in accordance with the provisions\ncontained in KRS 304.17A-708.\n(6) If an insurer chooses to collect an overpayment made to a provider thro ugh a\nrecoupment against future provider payments, the insurer shall, within twenty -four\n(24) months from the date that the insurer paid the claim, and at the actual time of\nrecoupment give the provider written or electronic documentation that specifies:\n(a) The amount of the recoupment;\n(b) The covered person's name to whom the recoupment applies;\n(c) Patient identification number; and\n(d) Date of service.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29336","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:48Z","sha256":"9dbc9776317fcb849f50aea5eea0c7a619a0ebe8489a8014861b7aaf0c301759","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-712","next":"us-ky/krs-304.17a-716"},"notice":"GroundRules: Original legal text. Not legal advice."}