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Bill

LC 3979

Require access to health insurer claim file by the insured

2025 Regular Session

Montana bill requiring health insurers to grant patients access to their complete claim files upon request, increasing claim transparency and appeal rights.

(LC) Draft Died in Process
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Bill Summary · LC 3979

Legislative bill overview

LC 3979 would require health insurers to provide insured individuals with access to their complete claim files upon request. This would give patients the right to review documentation, decisions, and communications related to their health insurance claims without restriction or delay.

Why is this important

Access to claim files is critical for patients who need to understand claim denials, appeal decisions, or verify billing accuracy. Currently, insurers' disclosure obligations vary by state and situation, leaving many patients unable to fully understand why claims were denied or how decisions were made, which can impede their ability to appeal or seek care alternatives.

Potential points of contention

  • Administrative burden: Insurers may argue that unrestricted file access creates operational costs and requires new systems to organize and redact sensitive information appropriately
  • Privacy and legal protections: Balancing patient access with protections for attorney-client privileged communications, medical peer review materials, and trade secrets within claim decision processes
  • Scope definition: Disagreement over what constitutes a "claim file"—whether it includes internal notes, actuarial data, or communications between insurers and providers that patients may not fully understand without context

Compiled from official sources — confirm details with the bill’s official record.

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