State Codes and Statutes

Statutes > North-carolina > Chapter_58 > GS_58-50-93

§ 58‑50‑93. Disclosure requirements.

(a)        Each insurer shallinclude a description of the external review procedures in or attached to thepolicy, certificate, membership booklet, outline of coverage, or other evidenceof coverage it provides to covered persons.

(b)        The descriptionrequired under subsection (a) of this section shall include a statement thatinforms the covered person of the right of the covered person to file a requestfor an external review of a noncertification, noncertification appeal decisionor a second‑level grievance review decision upholding a noncertificationwith the Commissioner. The statement shall include the telephone number andaddress of the Commissioner.

(c)        In addition tosubsection (b) of this section, the statement shall inform the covered personthat, when filing a request for an external review, the covered person will berequired to authorize the release of any medical records of the covered personthat may be required to be reviewed for the purpose of reaching a decision onthe external review. (2001‑446, s. 4.5.)

State Codes and Statutes

Statutes > North-carolina > Chapter_58 > GS_58-50-93

§ 58‑50‑93. Disclosure requirements.

(a)        Each insurer shallinclude a description of the external review procedures in or attached to thepolicy, certificate, membership booklet, outline of coverage, or other evidenceof coverage it provides to covered persons.

(b)        The descriptionrequired under subsection (a) of this section shall include a statement thatinforms the covered person of the right of the covered person to file a requestfor an external review of a noncertification, noncertification appeal decisionor a second‑level grievance review decision upholding a noncertificationwith the Commissioner. The statement shall include the telephone number andaddress of the Commissioner.

(c)        In addition tosubsection (b) of this section, the statement shall inform the covered personthat, when filing a request for an external review, the covered person will berequired to authorize the release of any medical records of the covered personthat may be required to be reviewed for the purpose of reaching a decision onthe external review. (2001‑446, s. 4.5.)


State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_58 > GS_58-50-93

§ 58‑50‑93. Disclosure requirements.

(a)        Each insurer shallinclude a description of the external review procedures in or attached to thepolicy, certificate, membership booklet, outline of coverage, or other evidenceof coverage it provides to covered persons.

(b)        The descriptionrequired under subsection (a) of this section shall include a statement thatinforms the covered person of the right of the covered person to file a requestfor an external review of a noncertification, noncertification appeal decisionor a second‑level grievance review decision upholding a noncertificationwith the Commissioner. The statement shall include the telephone number andaddress of the Commissioner.

(c)        In addition tosubsection (b) of this section, the statement shall inform the covered personthat, when filing a request for an external review, the covered person will berequired to authorize the release of any medical records of the covered personthat may be required to be reviewed for the purpose of reaching a decision onthe external review. (2001‑446, s. 4.5.)