SENATE BILL REPORT

SB 5539

BYSenator Moore

Providing checks for health care service claims be made out to the provider.

Senate Committee on Financial Institutions

Senate Hearing Date(s):March 6, 1987

Senate Staff:Phil Sorensen (786-7470)

AS OF MARCH 5, 1987

BACKGROUND:

Claims for services rendered under the provisions of health care service contracts are paid directly to participating providers.  Nonparticipating providers receive a check payable to both the subscriber and the provider.

A participating provider is one who has contracted directly with the health care service contractor to provide services at specified rates.  The participating provider may not charge the subscriber an additional amount over the specified rate.  In return, the provider receives among other benefits expedited and direct payment.

SUMMARY:

At the written request of a health care service contract subscriber, checks in payment for health care services rendered by specified providers shall be issued to, and in the single name of, the provider.  All beneficiaries are provided a copy of all claims processing done by health care service contractors.

Fiscal Note:      none requested