62Q.71 NOTICE TO ENROLLEES.Each health plan company shall provide to enrollees a clear and concise description of its complaint resolution procedure,
if applicable under section
62Q.68, subdivision 1, and the procedure used for utilization review as defined under chapter 62M as part of the member handbook, subscriber contract,
or certificate of coverage. If the health plan company does not issue a member handbook, the health plan company may provide
the description in another written document. The description must specifically inform enrollees:
(1) how to submit a complaint to the health plan company;(2) if the health plan includes utilization review requirements, how to notify the utilization review organization in a timely
manner and how to obtain certification for health care services;(3) how to request an appeal either through the procedures described in sections
62Q.69 and
62Q.70 or through the procedures described in chapter 62M;
(4) of the right to file a complaint with either the commissioner of health or commerce at any time during the complaint and
appeal process;(5) of the toll-free telephone number of the appropriate commissioner; and(6) of the right to obtain an external review under section
62Q.73 and a description of when and how that right may be exercised.
History: 1999 c 239 s 37; 2003 c 2 art 1 s 8