(a) Every healthbenefit plan utilizing a provider network shall maintain a provider directorythat includes a listing of network providers available to insureds and shallupdate the listing no less frequently than once a year. In addition, everyhealth benefit plan shall maintain a telephone system and may maintain anelectronic or on‑line system through which insureds can access up‑to‑datenetwork information. If the health benefit plan produces printed directories,the directories shall contain language disclosing the date of publication,frequency of updates, that the directory listing may not contain the latestnetwork information, and contact information for accessing up‑to‑datenetwork information.
(b) Each directorylisting shall include the following network information:
(1) The provider's name,address, telephone number, and, if applicable, area of specialty.
(2) Whether the providermay be selected as a primary care provider.
(3) To the extent knownto the health benefit plan, an indication of whether the provider:
a. Is or is notcurrently accepting new patients.
b. Has any otherrestrictions that would limit an insured's access to that provider.
(c) The directorylisting shall include all of the types of participating providers. Upon aparticipating provider's written request, the insurer shall also list in thedirectory, as part of the participating provider's listing, the names of anyallied health professionals who provide primary care services under the supervisionof the participating provider and whose services are covered by virtue of theinsurer's contract with the supervising participating provider and whosecredentials have been verified by the supervising participating provider. Theseallied health professionals shall be listed as a part of the directory listingfor the participating provider upon receipt of a certification by thesupervising participating provider that the credentials of the allied healthprofessional have been verified consistent with the requirements for the typeof information required to be verified under G.S. 58‑3‑230. (2001‑446, s. 2.2.)
(a) Every healthbenefit plan utilizing a provider network shall maintain a provider directorythat includes a listing of network providers available to insureds and shallupdate the listing no less frequently than once a year. In addition, everyhealth benefit plan shall maintain a telephone system and may maintain anelectronic or on‑line system through which insureds can access up‑to‑datenetwork information. If the health benefit plan produces printed directories,the directories shall contain language disclosing the date of publication,frequency of updates, that the directory listing may not contain the latestnetwork information, and contact information for accessing up‑to‑datenetwork information.
(b) Each directorylisting shall include the following network information:
(1) The provider's name,address, telephone number, and, if applicable, area of specialty.
(2) Whether the providermay be selected as a primary care provider.
(3) To the extent knownto the health benefit plan, an indication of whether the provider:
a. Is or is notcurrently accepting new patients.
b. Has any otherrestrictions that would limit an insured's access to that provider.
(c) The directorylisting shall include all of the types of participating providers. Upon aparticipating provider's written request, the insurer shall also list in thedirectory, as part of the participating provider's listing, the names of anyallied health professionals who provide primary care services under the supervisionof the participating provider and whose services are covered by virtue of theinsurer's contract with the supervising participating provider and whosecredentials have been verified by the supervising participating provider. Theseallied health professionals shall be listed as a part of the directory listingfor the participating provider upon receipt of a certification by thesupervising participating provider that the credentials of the allied healthprofessional have been verified consistent with the requirements for the typeof information required to be verified under G.S. 58‑3‑230. (2001‑446, s. 2.2.)
(a) Every healthbenefit plan utilizing a provider network shall maintain a provider directorythat includes a listing of network providers available to insureds and shallupdate the listing no less frequently than once a year. In addition, everyhealth benefit plan shall maintain a telephone system and may maintain anelectronic or on‑line system through which insureds can access up‑to‑datenetwork information. If the health benefit plan produces printed directories,the directories shall contain language disclosing the date of publication,frequency of updates, that the directory listing may not contain the latestnetwork information, and contact information for accessing up‑to‑datenetwork information.
(b) Each directorylisting shall include the following network information:
(1) The provider's name,address, telephone number, and, if applicable, area of specialty.
(2) Whether the providermay be selected as a primary care provider.
(3) To the extent knownto the health benefit plan, an indication of whether the provider:
a. Is or is notcurrently accepting new patients.
b. Has any otherrestrictions that would limit an insured's access to that provider.
(c) The directorylisting shall include all of the types of participating providers. Upon aparticipating provider's written request, the insurer shall also list in thedirectory, as part of the participating provider's listing, the names of anyallied health professionals who provide primary care services under the supervisionof the participating provider and whose services are covered by virtue of theinsurer's contract with the supervising participating provider and whosecredentials have been verified by the supervising participating provider. Theseallied health professionals shall be listed as a part of the directory listingfor the participating provider upon receipt of a certification by thesupervising participating provider that the credentials of the allied healthprofessional have been verified consistent with the requirements for the typeof information required to be verified under G.S. 58‑3‑230. (2001‑446, s. 2.2.)
