Prior authorization by physician — Definitions

  1. Law
  2. Arkansas Code
  3. Public Utilities and Regulated Industries
  4. Insurance
  5. Group and Blanket Accident and Health Insurance
  6. General Provisions
  7. Prior authorization by physician — Definitions

Checkout our iOS App for a better way to browser and research.

  1. (a) As used in this section:

    1. (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. (2) “Telemedicine” means the same as defined in § 23-79-1601.

  2. (b) When conducting prior authorization, whether for healthcare services provided through telemedicine or provided in person, a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas shall make all adverse determinations for healthcare services, medications, or equipment prescribed by a physician.


Download our app to see the most-to-date content.