Reimbursement by health benefit or dental plans, criteria.

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Effective - 28 Aug 2004

332.122. Reimbursement by health benefit or dental plans, criteria. — 1. The determination of whether a service provided to a patient is covered or reimbursable under the terms of a health benefit or dental benefit plan and the creation and management of a health care provider network are:

(1) Deemed not to be the practice of dentistry or other profession governed by this chapter; and

(2) Not in any way subject to the provisions of this chapter.

2. Claims, records, and documents pertaining to the operations of a health carrier, health benefit plan, dental benefit plan, or health care provider network are not clinical and administrative records under section 332.051.

3. Nothing in subsection 1 or 2 of this section shall be construed as affecting the obligations of a health carrier, under chapters 354 and 376, as health carrier is defined in section 376.1350.

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(L. 2004 S.B. 1122)


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