Regulation .03 Payment to Nonparticipating Providers.
Regulation .03 Payment to Nonparticipating Providers.LinkCopy Citation
A.
A health maintenance organization shall calculate the amount owed to a nonparticipating provider for covered evaluation and management services provided to an enrollee in accordance with Regulation .05 of this chapter.
B.
A health maintenance organization shall calculate the amount owed to a nonparticipating provider for covered services other than evaluation and management services provided to an enrollee in accordance with Regulation .06 of this chapter.