§ 23-86-122. Prior approval process for experimental and investigational surgical products and medical devices — Definition

(a) As used in this section: (1) “Health carrier” means a: (A) Health maintenance organization; (B) Hospital medical service corporation; and (C) Disability insurance company; (2) “Health carrier” includes a: (A) Self-insured governmental or church plan; and (B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health […]

§ 23-86-123. Prior authorization by physician — Definitions

(a) As used in this section: (1) “Prior authorization” means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and (2) “Telemedicine” means the same as […]