(a)
(1) As used in this section, “insurer” means an insurance company, a health maintenance organization, a hospital and medical service corporation, or a self-insured health plan for employees of a governmental entity that provides dental benefits.
(2) As used in this section, “insurer” includes an outside review entity that contracts with an insurance company, a health maintenance organization, a hospital and medical service corporation, or a self-insured health plan for employees of a governmental entity that provides dental benefits.
(b) A denial of all or part of a dental claim based upon medical necessity shall be made by a dentist licensed in the United States who is a graduate of a Commission on Dental Accreditation accredited program.
(c) To facilitate expeditious resolution, the insurer shall provide, upon request, a written communication to the treating dentist with the name, state where licensed, license number, and direct telephone number of the reviewing dentist.
Structure Arkansas Code
Title 23 - Public Utilities and Regulated Industries
Chapter 79 - Insurance Policies Generally
Subchapter 1 - General Provisions
§ 23-79-103. Insurable interest — Personal insurance
§ 23-79-104. Insurable interest — Property
§ 23-79-105. Application required — Life and accident and health insurance
§ 23-79-106. Application — Use as evidence — Alteration
§ 23-79-107. Application — Statements as representations
§ 23-79-108. Return of premium to rejected applicant
§ 23-79-109. Filing and approval of forms — Definitions
§ 23-79-110. Forms and premium rates — Grounds for disapproval — Definitions
§ 23-79-111. Standard provisions
§ 23-79-113. Charter or bylaw provisions excluded — Exception
§ 23-79-117. Underwriters' and combination policies
§ 23-79-118. Noncomplying forms
§ 23-79-119. Construction of policies
§ 23-79-121. Delivery of policy
§ 23-79-122. Negotiability of premium notes
§ 23-79-123. Renewal by certificate
§ 23-79-125. Payment by insurer — Discharge
§ 23-79-126. Forms for proof of loss
§ 23-79-127. Claims administration by insurer not waiver
§ 23-79-128. Right to insure spouse's life
§ 23-79-129. Coverage of newborn infants
§ 23-79-130. Impairment of speech or hearing
§ 23-79-131. Exemption of proceeds — Life insurance
§ 23-79-132. Exemption of proceeds — Group life
§ 23-79-133. Exemption of proceeds — Accident and health insurance
§ 23-79-134. Exemption of proceeds — Annuity contracts — Assignability of rights
§ 23-79-135. Prompt payment of certain claims required
§ 23-79-136. Agreement for insurer to invest premium prohibited
§ 23-79-137. Coverage for adopted minors
§ 23-79-138. Information to accompany policies
§ 23-79-139. Benefits for alcohol or drug dependency treatment — Definition
§ 23-79-140. Mammograms — Breast ultrasounds — Definitions
§ 23-79-141. Children's Preventive Health Care Act
§ 23-79-142. Payment for services of psychological examiners
§ 23-79-144. Minor children — Certain provisions denying or restricting coverage void
§ 23-79-146. Subrogation recovery
§ 23-79-147. Prescription medication — Definitions
§ 23-79-148. Medical transportation services
§ 23-79-149. Prescription drug benefits
§ 23-79-150. Healthcare plan — Health carrier — Definitions
§ 23-79-151. Liability insurance — Notice requirements prior to expiration of policy
§ 23-79-153. Health insurance — Closing a block of business
§ 23-79-154. Reimbursement for physician assistant services
§ 23-79-155. Commercial general liability insurance
§ 23-79-156. Health insurance exchange — Coverage of abortions prohibited — Definitions — Findings
§ 23-79-158. Denials of dental claims
§ 23-79-159. Notification of drug formulary changes
§ 23-79-160. Health insurance information regarding Health Care Independence Program
§ 23-79-161. Payment for oral anticancer medications — Definitions