Utah Admin. Code R590-194-4 - Minimum Standards and General Provisions
(1) Preauthorization for dietary products may
be required if it is stated in the policy.
(2) Each insurer shall provide direct access
to a designated person familiar with dietary products to facilitate the
processing of claims.
(3) Dietary
products shall be paid under the major medical benefit as any other illness and
not under any limited benefit, such as durable medical equipment
(DME).
(4) An insurer may request
additional information required to determine the eligibility of the claim under
the terms of the policy.
(5)
(a) "Coverage for Metabolic Dietary Products
Standard version 2.1," adopted by the Utah Health Information Network (UHIN),
is incorporated by reference and is available on the department's website,
https://insurance.utah.gov.
(b)
This uniform billing standard shall be utilized for billing and processing
claims for dietary products.
Notes
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No prior version found.