58-17H-45. Urgent care requests--Notice of determination--Failure to submit necessary information as grounds for denial of certification.
144 words·~1 min read·
/sd/title-58/chapter-58-17/58-17h-45·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The health carrier shall notify the covered person or, if applicable, the covered person's authorized representative, of its determination with respect to the urgent care request as soon as possible, but in no event more than forty-eight hours after the earlier of:
(1)The health carrier's receipt of the requested specified information; or
(2)The end of the period provided for the covered person or, if applicable, the covered person's authorized representative, to submit the requested specified information.
If the covered person or the covered person's authorized representative fails to submit the information before the end of the period of the extension, as specified in § 58-17H-44 , the health carrier may deny the certification of the requested benefit. If the health carrier's determination is an adverse determination, the health carrier shall provide notice of the adverse determination in accordance with § 58-17H-32 .