33-24-54
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33-24-54.
(a)
Notwithstanding any provisions of Code Sections 33-1-3, 33-1-5, and 33-24-17 and
Chapter 20 of this title or any other provisions of this title which might be
construed to the contrary, whenever an accident and sickness insurance policy,
subscriber contract, or self-insured health benefit plan, by whatever name
called, which is issued or administered by a person licensed under this title
provides that any of its benefits are payable to a participating or preferred
provider of health care services licensed under the provisions of Chapter 4 of
Title 26 or of Chapter 9, 11, 30, 34, 35, or 39 of Title 43 or of Chapter 11 of
Title 31 for services rendered, the person licensed under this title shall be
required to pay such benefits either directly to any similarly licensed
nonparticipating or nonpreferred provider who has rendered such services, has a
written assignment of benefits, and has caused written notice of such assignment
to be given to the person licensed under this title or jointly to such
nonparticipating or nonpreferred provider and to the insured, subscriber, or
other covered person; provided, however, that in either case the person licensed
under this title shall be required to send such benefit payments directly to the
provider who has the written assignment. When payment is made directly to a
provider of health care services as authorized by this Code section, the person
licensed under this title shall give written notice of such payment to the
insured, subscriber, or other covered person.
(b)
Nothing contained in this Code section shall be deemed to prohibit the payment
of different levels of benefits or from having differences in coinsurance
percentages applicable to benefit levels for services provided by participating
or preferred providers and nonparticipating or nonpreferred providers as
otherwise authorized under the provisions of Code Sections 33-30-20 through
33-30-27.
(c)
Payments made by a person licensed under this title under subsection (a) of this
Code section to a nonparticipating or nonpreferred provider or jointly to the
provider and the insured, subscriber, or other covered person shall discharge
such
persońs
obligation with respect to the amount so paid.
(d)
The provisions of this Code section shall not apply to credit insurance,
disability income insurance, or limited accident and sickness policies such as
hospital indemnity policies, specified disease policies, limited accident
policies, or similar limited policies.