55 Pa. Code § 1163.501. Provider right to appeal.

RIGHT OF APPEAL

§ 1163.501. Provider right to appeal.

(a)  The hospital’s right of appeal is under Chapter 1101 (relating to general provisions).
(b)  Hospitals and practitioners do not have the right to a separate appeal on the same inpatient case. For purposes of this chapter, inpatient services are considered to be those services provided by hospital personnel. Practitioner appeals relating to inpatient services are expected to be resolved through the utilization review process.
(c)  For cases undergoing the appeal process, payment, including adjustments, will be withheld until the case is adjudicated.

Source

   The provisions of this §  1163.501 adopted June 22, 1984, effective July 1, 1984, 14 Pa.B. 2185.

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