Agreements With Physicians

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A medical service plan corporation may enter into agreements with physicians qualified as set out in §56-27-108, under which the physicians become participating physicians of a plan operated by the corporation, and may make to the physicians payments that have accrued to them by reason of services performed under the plan and on behalf of the corporation by them. Payment for medical services shall be made only to a participating physician unless otherwise provided for in this chapter, except that the corporation, in the case of emergency services rendered to a subscriber, may reimburse any doctor of medicine who would be eligible to become a participating physician except for residence or state by which licensed, in accordance with the rates adopted by the board of directors with respect to participating physicians. A medical service plan corporation may enter into contracts for the payment of medical services to the subscribers or members of similar medical service plan corporations of other states subject to the supervision of other states, and shall have the right to reimburse any other medical service plan corporation or physicians of another state or other counties of this state in which the corporation does not transact business for services rendered to its subscribers or beneficiaries named in the certificates issued to the subscribers at the same rate paid participating physicians under the certificate of the subscriber. The contracts between the medical service plan corporation and physicians shall be subject to the supervision of and the approval of the commissioner.


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