31A-22-639 - Statement of preauthorization.
31A-22-639. Statement of preauthorization.
(1) An insurer who requires preauthorization or preapproval for coverage under accidentand health insurance shall, beginning January 1, 2011, provide an enrollee with a statement ofpreauthorization if:
(a) the applicable CPT codes have been submitted to the insurer to determine whether aparticular procedure is covered under the terms of the accident and health insurance policy;
(b) the enrollee has met the requirements for preauthorization of the procedure orencounter; and
(c) the enrollee requests a statement of preauthorization.
(2) A statement of preauthorization under Subsection (1) may be sent:
(a) by mail; or
(b) electronically.
(3) A statement of preauthorization shall include a statement that the preauthorization is:
(a) not a guarantee of payment by an insurer; and
(b) subject to the policy and contract provisions of the accident and health insurancecontract.
(1) An insurer who requires preauthorization or preapproval for coverage under accidentand health insurance shall, beginning January 1, 2011, provide an enrollee with a statement ofpreauthorization if:
(a) the applicable CPT codes have been submitted to the insurer to determine whether aparticular procedure is covered under the terms of the accident and health insurance policy;
(b) the enrollee has met the requirements for preauthorization of the procedure orencounter; and
(c) the enrollee requests a statement of preauthorization.
(2) A statement of preauthorization under Subsection (1) may be sent:
(a) by mail; or
(b) electronically.
(3) A statement of preauthorization shall include a statement that the preauthorization is:
(a) not a guarantee of payment by an insurer; and
(b) subject to the policy and contract provisions of the accident and health insurancecontract.
Enacted by Chapter 204, 2010 General Session