Mo. Rev. Stat. § 376.690. Unanticipated out-of-network care, claim procedure–definitions–limitation on amount billed to patient–external arbitration process–rulemaking authority: Missouri Health Insurance Rate Transparency Act – Missouri

Status: Enacted
Year Enacted: 2018
Year Amended: 2019
File: Download

Health care professionals shall send any claim for charges incurred for unanticipated out-of-network care to the patient’s health carrier within one hundred eighty days of the delivery of the unanticipated out-of-network care. No health care professional who sends a claim to a health carrier under subsection 2 of this section shall send a bill to the patient for any difference between the reimbursement rate as determined under this subsection and the health care professional’s billed charge.

Key Issues: Provider Payment Benefit Design PRICE AND QUALITY TRANSPARENCY Surprise Billing or Balance Billing Cost-Sharing or Out-of-Pocket Costs HEALTHCARE COSTS

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Mo. Rev. Stat. § 376.690. Unanticipated out-of-network care, claim procedure–definitions–limitation on amount billed to patient–external arbitration process–rulemaking authority: Missouri Health Insurance Rate Transparency Act – Missouri

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