§ 33-20C-7. Disclosure of Health Benefit Plan Surprise Bill Rating in Advertisement; Other Disclosures; Regulation; Optional Annual Reporting
Each insurer that advertises or designates any hospital as in-network shall be required to disclose the relevant health benefit plan surprise bill rating within such advertisement, notwithstanding the type or form of such advertisement. If a health benefit plan surprise bill rating is less than four checkmarks, each insurer advertising a hospital as in-network shall […]
§ 33-20C-1. Definitions
As used in this chapter, the term: “Covered person” means a policyholder, subscriber, enrollee, or other individual participating in a health benefit plan. “Facility” means an institution providing physical, mental, or behavioral health care services or a healthcare setting, including, but not limited to, hospitals; licensed inpatient centers; ambulatory surgical centers; skilled nursing facilities; residential […]
§ 33-20C-2. Online Provider Directories; Printed Directories by Request; Required Content; Accessibility; Public Health Emergency
An insurer shall post on its website a current and accurate electronic provider directory for each of its network plans with the information described in Code Section 33-20C-4. Such online provider directory shall be easily accessible in a standardized, downloadable, searchable, and machine readable format. In making the provider directory available online, the insurer shall […]
§ 33-20C-3. Required and Accurate Information in Directories; Reporting; Reimbursement for Reliance
The insurer shall include in both its online and print directories a clearly identifiable telephone number and either a dedicated e-mail address or a link to a dedicated webpage that covered persons or the general public may use to report to the insurer inaccurate information listed in the provider directory. Whenever an insurer receives such […]
§ 33-20C-4. Information and Searchable Format for Directories; Exclusion for Dental Plans
The insurer shall make available through an online provider directory, for each network plan, the following information, in a searchable format: For healthcare professionals: Name; Gender; Contact information; Participating office location or locations; Specialty, if applicable; Board certifications, if applicable; Medical group affiliations, if applicable; Participating facility affiliations, if applicable; Languages spoken other than English […]
§ 33-20C-5. Printed Directories; Accuracy; Application to Standalone Dental Plans
The insurer shall make available in print, upon request, the following provider directory information for the applicable network plan: For healthcare professionals: Name; Contact information; Participating office location or locations; Specialty, if applicable; Languages spoken other than English, if applicable; and Whether accepting new patients; For hospitals: Hospital name; Hospital type, such as acute, rehabilitation, […]
§ 33-20C-6. Exclusion for Services Provided Through Department of Community Health
This chapter shall not apply to the provision of health care services pursuant to a contract entered into by an insurer and the Department of Community Health for recipients of Medicaid or PeachCare for Kids and the state health benefit plan under Article 1 of Chapter 18 of Title 45. History. Code 1981, § 33-20C-6 […]