South Dakota § 58-17K-3 Cost-sharing information disclosed--Required internet method and format.

South Dakota Statutes

§ 58-17K-3 — Cost-sharing information disclosed--Required internet method and format.

South Dakota·Title 58 INSURANCE·Ch. 58-17J PATIENT CHOICE IN SELECTION OF HEALTH CARE PROVIDER

The cost-sharing information to be provided under this chapter shall be made available without a subscription or other fee through a self-service tool on a website that provides real-time responses based on cost-sharing information that is accurate at the time of request. A health insurer shall ensure the self-service tool allows enrollees to:

(1)Search for cost-sharing information for a covered item or service by an in-network provider by inputting:

(a)A billing code or a descriptive term;

(b)The name of an in-network provider; and (c) Other factors utilized by the health insurer that are relevant for determining the applicable cost-sharing information;

(2)Search for an out-of-network allowed amount, percentage of billed charges, or other rate for a covered item or serv

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The cost-sharing information to be provided under this chapter shall be made available without a subscription or other fee through a self-service tool on a website that provides real-time responses based on cost-sharing information that is accurate at the time of request. A health insurer shall ensure the self-service tool allows enrollees to: (1) Search for cost-sharing information for a covered item or service by an in-network provider by inputting: (a) A billing code or a descriptive term; (b) The name of an in-network provider; and (c) Other factors utilized by the health insurer that are relevant for determining the applicable cost-sharing information; (2) Search for an out-of-network allowed amount, percentage of billed charges, or other rate for a covered item or service by an out-of-network provider by inputting: (a) A billing code or a descriptive term; and (b) Other factors utilized by the health insurer that are relevant for determining the applicable out-of-network allowed amount or other rate; and (3) Refine and reorder search results based on geographic proximity of in-network providers and the amount of the enrollee's estimated cost-sharing liability.

South Dakota § 58-17K-3 (Cost-sharing information disclosed--Required internet method and format.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.