• Summary date: Apr 3 2019 - More information

    Enacts GS 58-3-226 to mandate that a reimbursement contract between a health care provider and an insurer or a third-party payor require that reimbursement be made directly to the health care provider for any covered service required by the health care provider under the contract.

    Requires an insurer or third-party payor to accept and honor a completed and validly executed assignment of benefits agreement that assigned the insured's reimbursement benefits to a health care provider. Applies only if there is no reimbursement contract between a health care provider and an insurer or a third-party payor.

    Establishes that the prompt claims payment provisions of GS 58-3-225 apply to payments made under reimbursement contracts or through an assignment of benefits agreement.

    Defines health benefit plan, health care provider, and insured. Specifies that health benefit plan applies to limited-scope dental and vision insurance.

    Applies to reimbursement contracts and assignment of benefit agreements entered into or amended on or after July 1, 2019.

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