Font ResizeHealth insurance jargon can be difficult to understand, says Sen. Karen Mayne, D-West Valley City, and SB39 will let patients know exactly what pre-authorized coverage they have for medical care.
While patients already can call their insurer for information about having care pre-approved for coverage, Mayne said her legislation would assure that across the industry in Utah, companies will send a written statement about that pre-authorization when asked to do so.
"Sometimes we don't understand exactly what was said; this is a clarification of that," Mayne said. She suspects SB39 will only occasionally be used to obtain such statements by e-mail or mail, but will make the pre-approval process more understandable and possibly reduce the number of appeals after denials and the associated costs.
Others think it could make things more expensive.
Every new mandate required of insurers "increases administrative burden and increases costs," said Jeff Hartley, a representative of industry group America's Health Insurance Plans. He said SB39 could nudge expenses to the point smaller providers leave the state.
Hartley added the medical codes required to determine pre-approval could confuse patients.
But Mayne countered that SB39 is about minimizing confusion for patients by giving them a better way to understand their coverage and increasing their ability to communicate with their doctors and physicians.
The Senate
