83-9-47 - Third party payors required to notify health care providers of payment for services made directly to patient. - Mississippi Statutes

§ 83-9-47. Third party payors required to notify health care providers of payment for services made directly to patient.
 

(1)  As used in this section, the following terms shall be defined as follows: 

(a) "Third-party payor" means any insurer, nonprofit hospital service plan, health care service plan, health maintenance organization, self-insurer or any person or other entity which provides payment for medical and related services. 

(b) "Health care provider" means a physician, optometrist, chiropractor, dentist, podiatrist, pharmacist, psychologist or hospital licensed by the State of Mississippi. 

(c) "Patient" means any natural person who has received medical care or services from any medical care provider within the State of Mississippi. 

(2)  Any third-party payor who pays a patient or policyholder on behalf of a patient directly for medical care or services rendered by a health care provider shall provide information concerning the amount, date and nature of any such payment to the provider of services. The information may be provided by telephone, facsimile or by mailing a copy of the "explanation of benefits" to the provider. If the information is provided by sending a copy of the "explanation of benefits" to the provider, then the third-party payor may require that the reasonable cost of producing and mailing the information be paid by the provider. The requirements of this subsection shall not apply to the following: a fixed-indemnity policy, a limited benefit health insurance policy, medical payment coverage or personal injury protection coverage in a motor vehicle policy, coverage issued as a supplement to liability insurance or workers' compensation. 
 

Sources: Laws,  1991, ch. 474, § 1, eff from and after July 1, 1991.