§ 31A-22-639. Statement of preauthorization.

Latest version.

(1)

An insurer who requires preauthorization or preapproval for coverage under accident and health insurance shall, beginning January 1, 2011, provide an enrollee with a statement of preauthorization if:

(a)	the applicable CPT codes have been submitted to the insurer to determine whether a particular 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 or encounter; 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 insurance contract.

Enacted by Chapter 204, 2010 General Session

                    
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