State RegulationsCO specificDifficulty 2/5
A physical therapy clinic in Aurora mails a clean claim to a Colorado carrier, and the carrier lets the deadline to pay, deny, or settle the claim pass without action. Under C.R.S. § 10-16-106.5, what liability does the carrier face for the late resolution?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under C.R.S. § 10-16-106.5, the mailed clean claim had to be paid, denied, or settled within 45 calendar days. A carrier that misses the deadline owes 10% annual interest on the amount ultimately allowed from the due date, and if the claim remains unresolved after 90 days, a penalty of 20% of that amount is imposed on the 91st day.
Why the other options are wrong
- B) Mailed clean claims carry a 45-calendar-day deadline, so ignoring it does expose the carrier to statutory liability.
- C) The statute provides interest and a penalty on the amount ultimately allowed, not forfeiture of the whole claim to the provider.
- D) Treble damages are not a remedy the Colorado prompt-pay law provides for late claim resolution.
Memory hook
Paper claim and late? 10% interest, then 20% once 90 days pass.