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.
Enacted by Chapter 204, 2010 General Session