Section 58-17C-54 - Information required to be provided to covered persons and prospectivecovered persons.

58-17C-54. Information required to be provided to covered persons and prospective covered persons. In the certificate of coverage or member handbook provided to covered persons, a health carrier shall include a clear and comprehensive description of its utilization review procedures, including the procedures for obtaining review of adverse determinations, and a statement of rights and responsibilities of covered persons with respect to those procedures. A health carrier shall include a summary of its utilization review and benefit determination procedures in materials intended for prospective covered persons. A health carrier shall print on its membership cards a toll-free telephone number to call for utilization review and benefit decisions.

Source: SL 1999, ch 243, § 22; SL 2003, ch 250, § 12.