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Current as of January 01, 2025 | Updated by Findlaw Staff
(1) As used in this section, the term “health insurer” means a health insurer issuing individual or group coverage or a health maintenance organization issuing coverage through an individual or a group contract.
(2) Each health insurer shall prepare an advanced explanation of benefits upon receiving a patient estimate from a facility pursuant to s. 395.301(1). The health insurer must provide the advanced explanation of benefits to the insured no later than 1 business day after receiving the patient estimate from the facility or, in the case of a service scheduled at least 10 business days in advance, no later than 3 business days after receiving such estimate. The health insurer must provide an advanced explanation of benefits to the insured no later than 3 business days after the date on which the health insurer receives a request from the insured.
(3) At a minimum, the advanced explanation of benefits must include detailed coverage and cost-sharing information pursuant to the No Surprises Act, Title I of Division BB of the Consolidated Appropriations Act, 2021, Pub. L. No. 116-260.
Cite this article: FindLaw.com - Florida Statutes Title XXXVII. Insurance § 627.446. Advanced explanation of benefits - last updated January 01, 2025 | https://codes.findlaw.com/fl/title-xxxvii-insurance/fl-st-sect-627-446/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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