South Dakota Statutes

§ 58-17H-42 — Insufficient information for determination of prospective urgent care requests.

South Dakota·Title 58 INSURANCE·Ch. 58-17E UTILIZATION REVIEW AND BENEFIT DETERMINATIONS

If the benefit request involves a prospective review urgent care request, the provisions of § 58-17H-41 apply only in the case of a failure that:

(1)Is a communication by a covered person or, if applicable, the covered person's authorized representative, that is received by a person or organizational unit of the health carrier responsible for handling benefit matters; and (2) Is a communication that refers to a specific covered person, a specific medical condition or symptom, and a specific health care service, treatment, or provider for which approval is being requested. Commission Note:

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South Dakota § 58-17H-42 (Insufficient information for determination of prospective urgent care requests.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

SL 2011, ch 219, § 67.

Nearby Sections

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