West Virginia Code
Article 25. Health Care Corporations
§33-25-22. Assignment of Certain Benefits in Dental Care Insurance Coverage

(a) Any entity regulated under this article that provides dental care coverage to a covered person shall honor an assignment, made in writing by the person covered under the policy, of payments due under the policy to a dentist or a dental corporation for services provided to the covered person that are covered under the policy. Upon notice of the assignment, the entity shall make payments directly to the provider of the covered services. A dentist or dental corporation with a valid assignment may bill the entity and notify the entity of the assignment. Upon request of the entity, the dentist or dental corporation shall provide a copy of the assignment to the entity.
(b) A covered person may revoke an assignment made pursuant to subsection (a) of this section with or without the consent of the provider. The revocation shall be in writing. The covered person shall provide notice of the revocation to the entity. The entity shall send a copy of the revocation notice to the dentist or dental corporation subject to the assignment. The revocation is effective when both the entity and the provider have received a copy of the revocation notice. The revocation is only effective for any charges incurred after both parties have received the revocation notice.
(c) If, under an assignment authorized in subsection (a) of this section, a dentist or dental corporation collects payment from a covered person and subsequently receives payment from the entity, the dentist or dental corporation shall reimburse the covered person, less any applicable copayments, deductibles, or coinsurance amounts, within 45 days.
(d) Nothing in this section limits an entitys ability to determine the scope of the entitys benefits, services, or any other terms of the entitys policies or to negotiate any contract with a licensed health care provider regarding reimbursement rates or any other lawful provisions.
(e) Any entity providing dental care shall provide conspicuous notice to the covered person that the assignment of benefits is optional, and that additional payments may be required if the assigned benefits are not sufficient to pay for received services.

Structure West Virginia Code

West Virginia Code

Chapter 33. Insurance

Article 25. Health Care Corporations

§33-25-1. Declaration of Policy

§33-25-2. Definitions

§33-25-3. Incorporation; Purposes; Name; Limitations

§33-25-4. Board of Directors

§33-25-5. Exemption From Taxes

§33-25-6. Supervision and Regulation by Insurance Commissioner; Exemption From Insurance Laws

§33-25-6a. Applicability of Insurance Fraud Prevention Act

§33-25-7. Licenses

§33-25-8. Commissioner to Enforce Article; Approval of Contracts, Forms and Rates; Reserve Fund; Membership Fee

§33-25-8a. Third Party Reimbursement for Mammography or Pap Smear or Human Papilloma Virus Testing

§33-25-8b. Third Party Reimbursement for Rehabilitation Services

§33-25-8c. Third Party Payment for Child Immunization Services

§33-25-8d. Coverage of Emergency Services

§33-25-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing

§33-25-8f. Required Use of Mail-Order Pharmacy Prohibited

§33-25-8g. Third-Party Reimbursement for Kidney Disease Screening

§33-25-8h. Required Coverage for Dental Anesthesia Services

§33-25-8i. Maternity Coverage

§33-25-8j. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications

§33-25-8k. Eye Drop Prescription Refills

§33-25-8l. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs

§33-25-8m. Step Therapy

§33-25-8n. Coverage for Amino Acid-Based Formulas

§33-25-8o. Substance Use Disorder

§33-25-8p. Prior Authorization

§33-25-8q. Fairness in Cost-Sharing Calculation

§33-25-8r. Mental Health Parity

§33-25-8s. Incorporation of the Health Benefit Plan Network Access and Adequacy Act

§33-25-8t. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs

§33-25-9. Annual Report

§33-25-10. Examination of Corporation; Report of Examination; Objections to Report; Access to Books, Records, etc.; Removal of Records, etc., From State

§33-25-10a. Loss Ratio

§33-25-11. Rules and Regulations

§33-25-12. Required Provisions in Contracts Made by Corporation With Physicians, Dentists, etc., Hospitals and Other Health Agencies

§33-25-13. Contracts to Be Furnished to Subscribers; Payments for Subscribers by Others; Wage Deductions

§33-25-14. Advancement of Money to Corporation

§33-25-16. Disposition of Fees and Charges

§33-25-17. Bonds of Corporation Officers and Employees

§33-25-18. Annual Audited Financial Report

§33-25-19. Administrative Supervision

§33-25-20. Policies Discriminating Among Health Care Providers

§33-25-21. Authority of Commissioner to Promulgate Rules and Regulations Regarding Affiliate and Subsidiary Operating Results

§33-25-22. Assignment of Certain Benefits in Dental Care Insurance Coverage