RCW 48.43.747
178 words·~1 min read·
/wa/title-48/chapter-48-43/48-43-747·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)A dental only plan offered by a carrier or limited health care service contractor, as defined in RCW 48.44.035 , may not deny coverage for procedures solely on the basis that the procedures were performed on the same day.
(2)Nothing in this section shall prevent a dental only plan offered by a carrier or limited health care service contractor from denying a claim for coverage where such denial relates in whole or in part to any of the following:
(a)Limitations intended to prevent fraud, waste, and abuse;
(b)A claim indicating unbundling of procedure elements where payment for a service bundles multiple procedure elements;
(c)Clinical appropriateness;
(d)Medical necessity;
(e)A final benefit decision that has been pended due to the need for further documentation or provider narrative; or
(f)Plan benefit limitations.
[ 2025 c 219 s 1 .]
Notes:
Rules — 2025 c 219 ss 1 and 2: "The insurance commissioner may adopt any rules necessary to implement sections 1 and 2 of this act." [ 2025 c 219 s 3 .]