FIRST REGULAR SESSION
SENATE BILL NO. 120
90TH GENERAL ASSEMBLY
INTRODUCED BY SENATOR SINGLETON.
Pre-filed December 1, 1998, and 1,000 copies ordered printed.
TERRY L. SPIELER, Secretary.
S0425.01I
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to health insurance.
Section A. Chapter 376, RSMo, is amended by adding thereto one new section, to be known as section 376.1400, to read as follows:
376.1400. 1. Every health insurance carrier offering policies of insurance in this state shall use a standardized form for the explanation of benefits given to the health care provider whenever a claim is paid or denied. As used in this section, the term "health insurance carrier" shall have the meaning given to "health carrier" in section 376.1350.
2. The department of insurance shall develop the standardized form required by this section. The department shall consult with physicians and with health insurance carriers when developing a form. The form shall contain, but not be limited to, the following:
(1) The name of the insured;
(2) The insured's identification number;
(3) The date of service;
(4) Amount of charge;
(5) Explanation for any denial;
(6) The amount paid and any balance due;
(7) The procedure code;
(8) The patient's full name; and
(9) The phone number and name of whom to contact for questions on explanation of benefits.
3. The department of insurance shall implement this section through rulemaking procedures by January 1, 2000.
4. All health insurance carriers shall use the standard explanation of benefits form after January 1, 2000.