Medical transportation services

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  1. (a)

    1. (1) Every insurance policy, other than a policy excluded pursuant to subsection (d) of this section, that provides specific coverage exclusively for medical transportation services, that is sold, delivered, issued for delivery, renewed, or offered for sale in this state by an insurer shall contain a provision providing for direct reimbursement to the provider of covered medical transportation service, if the provider has not received payment for those services from any other source.

    2. (2) The service fee charged shall be in accordance with the American Ambulance Association practice guidelines and shall not be more than the normal charge for the services.

  2. (b) This section shall not apply if the provider for the medical transportation services has entered into a contract for direct payment with the insurer.

  3. (c)

    1. (1) For the purpose of this section, “direct reimbursement” means the insurer shall pay the medical transportation service directly, pursuant to a claim filed by the insured, and the medical transportation provider shall not demand payment from the insured until having received payment from the insurer.

    2. (2) Upon receiving payment from the insurer, the medical transportation provider may demand payment from the insured for any unpaid portion of the provider's fee.

  4. (d) This section shall not apply to any accident and healthcare policy, whether the policy is in the form of a health maintenance organization evidence of coverage or healthcare plan as defined in § 23-76-102(4) and (5), or an accident and health policy governed by §§ 23-85-101 — 23-85-134, 23-85-136, and 23-85-137, or a group and blanket accident and health insurance policy governed by §§ 23-86-101 — 23-86-104, 23-86-106 — 23-86-118, or a Medicare supplement policy, or any other form.


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