58-17H-42. Insufficient information for determination of prospective urgent care requests.
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/sd/title-58/chapter-58-17/58-17h-42·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
If the benefit request involves a prospective review urgent care request, the provisions of § 58-17H-41 apply only in the case of a failure that:
(1)Is a communication by a covered person or, if applicable, the covered person's authorized representative, that is received by a person or organizational unit of the health carrier responsible for handling benefit matters; and
(2)Is a communication that refers to a specific covered person, a specific medical condition or symptom, and a specific health care service, treatment, or provider for which approval is being requested.