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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
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27-10-20
Section 27-10-20 Procuring of surplus lines from unauthorized insurers. If certain insurance
coverages cannot be procured on terms acceptable to the insureds from authorized insurers,
such coverages, designated "surplus lines," may be procured from unauthorized insurers
subject to the terms and conditions of either subdivisions (1) or (2) of this section: (1)a.
The insurance must be procured through a licensed surplus line broker; b. The full amount
of insurance required must not be procurable, after diligent effort has been made to do so,
from among the insurers authorized to transact and actually transacting that kind and class
of insurance in this state or has been procured to the full extent such insurers are willing
to insure; c. The insurance must not be procured for the purpose of securing advantages as
to a lower premium rate than would be accepted by an authorized insurer; and d. This section,
and this surplus line law, does not apply as to life insurance or disability...
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27-19-39
Section 27-19-39 Policies, etc., providing for reimbursement for visual service. Whenever any
policy of insurance or any medical service plan or hospital service contract or hospital and
medical service contract provides for reimbursement for any visual service in Alabama which
is within the lawful scope of practice of a duly licensed optometrist, as defined in Section
34-22-1, the insured or other person entitled to benefits under such policy shall be entitled
to reimbursement for such services, whether such services are performed by a duly licensed
physician or by a duly licensed optometrist, whichever the insured selects, notwithstanding
any provision to the contrary in any statute or in such policy, plan, or contract. Duly licensed
optometrists shall be entitled to participate in such policies, plans, or contracts providing
for visual services to the same extent as fully licensed physicians. (Acts 1967, No. 508,
p. 1224.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-39.htm - 1K - Match Info - Similar pages
27-26-5
Section 27-26-5 Reports of judgments and settlements; confidentiality; penalty. (a) Any insurance
company which sells medical liability insurance to Alabama physicians or their professional
corporations or professional associations, or to hospitals or other health care providers
shall be required to report to the state licensing agency which issues the license of the
physician, hospital, or other health care provider any final judgment or any settlement in
or out of court resulting from a claim or action for damages for personal injuries caused
by an error, omission, or negligence in the performance of professional services with or without
consent rendered by its policyholder within 30 days after entry of a judgment in court or
agreement to settle a claim in or out of court. (b) The report rendered to the appropriate
state agency shall consist of the name of the policyholder, or if the policyholder is a professional
corporation or professional association, the name of the physician or...
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27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection
(b), all utilization review agents shall meet the following minimum standards: (1) Notification
of a determination by the utilization review agent shall be mailed or otherwise communicated
to the provider of record or the enrollee or other appropriate individual within two business
days of the receipt of the request for determination and the receipt of all information necessary
to complete the review. (2) Any determination by a utilization review agent as to the necessity
or appropriateness of an admission, service, or procedure shall be reviewed by a physician
or determined in accordance with standards or guidelines approved by a physician. (3) Any
notification of determination not to certify an admission, service, or procedure shall include
the principal reason for the determination and the procedures to initiate an appeal of the
determination. (4) Utilization review agents shall maintain...
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27-59-3
Section 27-59-3 Implementation of coverage. (a) The benefits provided in this chapter shall
be subject to the same annual deductible or co-insurance established for all covered benefits
within a given policy. Private third party payors may not reduce or eliminate coverage due
to the requirements of this chapter. (b) A health benefit plan subject to this chapter may
not terminate services, reduce capitation payment, or otherwise penalize an attending physician
or health care provider who orders medical care consistent with this chapter. (c) Nothing
in this chapter is intended to expand the list of designations of covered providers as specified
in any health benefit plan. (Act 2008-502, p. 1106, ยง3.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-59-3.htm - 1K - Match Info - Similar pages
36-1-6.2
Section 36-1-6.2 Insurance coverage for state instrumentalities and agencies; prior contracts
and policies ratified. (a) Any instrumentality or agency of the State of Alabama, whose principal
activity consists of distributing goods or services by contract with the United States, or
any federal governmental corporation, and which are not covered by the provisions of Chapter
29 of this title, shall be subject to all the provisions of this section. Such instrumentality
or agency is hereby empowered to purchase and pay for group health, accident or hospitalization
insurance coverage for its officers and employees. Such instrumentality or agency is hereby
further authorized to contract with the State Employees' Insurance Board for group health,
accident or hospitalization insurance coverage, and under such terms, conditions, and costs
as the State Employees' Insurance Board and the instrumentality or agency shall mutually determine.
The cost or premium for such group health, accident or...
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45-16A-20
Section 45-16A-20 Definitions. As used in this article, the following terms shall have the
following meanings: (1) ALARM MONITORING SERVICE. A service that uses a device located at
a residence, place of business, or other fixed premises for both of the following purposes:
a. To receive signals from other devices located at or about the premises regarding a possible
threat at the premises to life, safety, or property, from burglary, fire, vandalism, bodily
injury, or other emergency. b. To transmit a signal regarding any threat by means of transmission
facilities of a municipality, municipal instrumentality, local exchange carrier, or one of
its affiliates to a remote monitoring center to alert a person at the center of the need to
inform the customer or another person or police, fire, rescue, security, or public safety
personnel of the threat, but does not include a service that uses a medical monitoring device
attached to an individual for the automatic surveillance of an ongoing...
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45-39-250
Section 45-39-250 Definitions. As used in this part, the following terms shall have the following
meanings: (1) ALARM MONITORING SERVICE. A service that uses a device located at a residence,
place of business, or other fixed premises for both of the following purposes: a. To receive
signals from other devices located at or about the premises regarding a possible threat at
the premises to life, safety, or property, from burglary, fire, vandalism, bodily injury,
or other emergency. b. To transmit a signal regarding any threat by means of transmission
facilities of a municipality, municipal instrumentality, local exchange carrier, or one of
its affiliates to a remote monitoring center to alert a person at the center of the need to
inform the customer or another person or police, fire, rescue, security, or public safety
personnel of the threat, but does not include a service that uses a medical monitoring device
attached to an individual for the automatic surveillance of an ongoing medical...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/45-39-250.htm - 5K - Match Info - Similar pages
11-50B-2
Section 11-50B-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) ADVANCED TELECOMMUNICATIONS CAPABILITY. Without regard to any transmission media
or technology, high-speed, switched, broadband telecommunications capability that enables
users to originate and receive high-quality voice, data, graphics, and video telecommunications
using any technology. (2) ADVANCED TELECOMMUNICATIONS SERVICE. Without regard to any transmission
media or technology, the provision of high-speed, switched, broadband telecommunications capability
that enables users to originate and receive high-quality voice, data, graphics, and video
telecommunications using any technology. (3) ALARM MONITORING SERVICE. A service that uses
a device located at a residence, place of business, or other fixed premises for both of the
following purposes: a. To receive signals from other devices located at or about such premises
regarding a possible threat at the premises to life,...
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