- (a) Each PBM's claims processing service shall be supported by a set of written policies, procedures, and performance standards related to timeliness in payment of claims and its financial operations.
- (b) Each PBM shall develop and implement a claims processing internal audit and a quality assurance program to monitor and improve claims processing services.
- (c) Each PBM shall be accessible to insureds, insurers, and pharmacists by telephone to respond to inquiries about claims payments.
History Note: Authority G.S. 58-2-40;58-56A-1(4); 58-56A-2;
Eff. September 1, 2025.