31A-22-639. Statement of preauthorization.
(1) An insurer who requires preauthorization or preapproval for coverage under accident and health insurance shall, beginning January 1, 2011, provide an enrollee with a statement of preauthorization if: the applicable CPT codes have been submitted to the insurer to determine whether a particular procedure is covered under the terms of the accident and health insurance policy; the enrollee has met the requirements for preauthorization of the procedure or encounter; and the enrollee requests a statement of preauthorization.
(2) A statement of preauthorization under Subsectionmay be sent: (1) by mail; or electronically.
(3) A statement of preauthorization shall include a statement that the preauthorization is: not a guarantee of payment by an insurer; and subject to the policy and contract provisions of the accident and health insurance contract.