332.122. Reimbursement by health benefit or dental plans, criteria. - Missouri Statutes

Reimbursement by health benefit or dental plans, criteria.

332.122. 1. The determination of whether a service provided to apatient is covered or reimbursable under the terms of a health benefit ordental benefit plan and the creation and management of a health careprovider network are:

(1) Deemed not to be the practice of dentistry or other professiongoverned by this chapter; and

(2) Not in any way subject to the provisions of this chapter.

2. Claims, records, and documents pertaining to the operations of ahealth carrier, health benefit plan, dental benefit plan, or health careprovider network are not clinical and administrative records under section332.051.

3. Nothing in subsection 1 or 2 of this section shall be construed asaffecting the obligations of a health carrier, under chapters 354 and 376,RSMo, as health carrier is defined in section 376.1350, RSMo.

(L. 2004 S.B. 1122)