Health care provider payment information -- Notice of admissions.
Utah Code § 31A-22-637
in effect31A-22-637. Health care provider payment information -- Notice of admissions.
(1) For purposes of this section, "insurer" is as defined in Section 31A-22-636.
(2)
(a) An insurer shall provide its health care providers who are under contract with the insurer access to current information necessary for the health care provider to determine:
(i) the effect of procedure codes on payment or compensation before a claim is submitted for a procedure;
(ii) the plans and carrier networks that the health care provider is subject to as part of the contract with the carrier; and
(iii) in accordance with Subsection 31A-26-301.6(10)(f), the specific rate and terms under which the provider will be paid for health care services.
(b) The information required by Subsection (2)(a) may be provided through a website, and if requested by the health care provider, notice of the updated website shall be provided by the carrier.
(3)
(a) An insurer may not require a health care provider by contract, reimbursement procedure, or otherwise to notify the insurer of a hospital in-patient emergency admission within a period of time that is less than one business day of the hospital in-patient admission, if compliance with the notification requirement would result in notification by the health care provider on a weekend or federal holiday.
(b) Subsection (3)(a) does not prohibit the applicability or administration of other contract provisions between an insurer and a health care provider that require pre-authorization for scheduled in-patient admissions.
Amended by Chapter 297, 2011 General Session
Source: Utah Office of Legislative Research and General Counsel (le.utah.gov)URL: https://le.utah.gov/xcode/Title31A/Chapter22/31A-22-S637.html?v=C31A-22-S637_1800010118000101Fetched: 10/26/2026