Your recipients will receive an email with this envelope shortly and will be able to access it on trellis. You can always see your envelopes by clicking the Inbox on the top right hand corner.
Your subscription has successfully been upgraded.
Sec. 38a-479. Definitions. Access to fee schedules. Fee information to be confidential. (a) As used in this section and section 38a-479b:
(1) “Contracting health organization” means a managed care organization, as defined in section 38a-478, or a preferred provider network, as defined in section 38a-479aa.
(2) “Provider” means a physician, surgeon, chiropractor, podiatrist, psychologist, optometrist, dentist, naturopath or advanced practice registered nurse licensed in this state or a group or organization of such individuals, who has entered into or renews a participating provider contract with a contracting health organization to render services to such organization's enrollees and enrollees' dependents.
(b) Each contracting health organization shall establish and implement a procedure to provide to each provider:
(1) Access via the Internet or other electronic or digital format to the contracting health organization's fees for (A) the current procedural terminology (CPT) codes applicable to such provider's specialty or, upon request, current dental terminology (CDT) codes, (B) the Health Care Procedure Coding System (HCPCS) codes applicable to such provider, and (C) such CPT codes, CDT codes and HCPCS codes as may be requested by such provider for other services such provider actually bills or intends to bill the contracting health organization, provided such codes are within the provider's specialty or subspecialty; and
(2) Access via the Internet or other electronic or digital format to the contracting health organization's policies and procedures regarding (A) payments to providers, (B) providers' duties and requirements under the participating provider contract, (C) inquiries and appeals from providers, including contact information for the office or offices responsible for responding to such inquiries or appeals and a description of the rights of a provider, enrollee and enrollee's dependents with respect to an appeal.
(c) The provisions of subdivision (1) of subsection (b) of this section shall not apply to any provider whose services are reimbursed in a manner that does not utilize current procedural terminology (CPT) or current dental terminology (CDT) codes.
(d) The fee information received by a provider pursuant to subdivision (1) of subsection (b) of this section is proprietary and shall be confidential, and the procedure adopted pursuant to this section may contain penalties for the unauthorized distribution of fee information, which may include termination of the participating provider contract.
(P.A. 06-178, S. 1; P.A. 07-54, S. 2; P.A. 09-204, S. 1; P.A. 11-132, S. 1; P.A. 19-155, S. 1.)
See Sec. 38a-193 for additional provisions re contracts between health care centers and participating providers.
See Secs. 42-490 to 42-493, inclusive, for provisions re the selling, leasing, renting, assigning or granting of access to a contract or terms of a contract between health care providers and contracting entities.
Apr 30, 2024
Superior
New Haven County, CT
Mar 04, 2024
Fairfield County
Fairfield County, CT
Nov 21, 2023
Hartford County
Hartford County, CT
Aug 30, 2023
New Haven County
New Haven County, CT
Feb 27, 2024
Hartford County
Hartford County, CT
AAN-CV-15-6018031-S SUPERIOR COURT CHICAGO TITLE INSURANCE JUDICIAL DISTRICT OF ANSONTA/ COMPANY MILFORD VS. AT MILFORD ELIZABETH LAPUMA, ET. AL. MAY 13, 2015 RE UEST TO REVISE Pursuant to Section 10-35 of the Connecticut Practice Boo…
Mar 16, 2015
DOCKET NO. HHD-CV-18-6095387-S MONTAVIOUS FINLEY ) SUPERIOR COURT ) ) ) V. ) …
May 31, 2018
DOCKET NO.: MMX-CV19-6023735-S : SUPERIOR COURT ANN L. GILLESPIE-WHITE J.D. OF MIDDLESEX V. : AT MIDDLETOWN GOVERNMENT EMPLOYEES INSURANCE CO.: OCTOBER 12, 2022 PLAINTIFF’S DISCLOSURE OF EX…
Jan 18, 2019
DOCKET NO.: MMX-CV19-6023735-S : SUPERIOR COURT ANN L. GILLESPIE-WHITE J.D. OF MIDDLESEX V. : AT MIDDLETOWN GOVERNMENT EMPLOYEES INSURANCE CO.: DECMEBER 11, 2022 AMENDED PLAINTIFF’S DISCLOSURE OF E…
Jan 18, 2019
NO. HHD-CV19-6108505-S AFFORD-A-BAIL BONDS : SUPERIOR COURT VS. : J. D. OF HARTFORD CHRISTINE H. STEELE : FEBRUARY 11, 2021 DEFENDANT’S POST-TRIAL MEMORANDUM Th…
Mar 12, 2019
For full print and download access, please subscribe at https://www.trellis.law/.
Please wait a moment while we load this page.