Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.41 - Assignment of Benefits to Nonpreferred Providers
Section 31.10.41.06 - Required Disclosure for Nonpreferred Providers Seeking Assignment of Benefits
Current through Register Vol. 51, No. 19, September 20, 2024
A. Except for a nonpreferred provider who is an on-call physician or a hospital-based physician, a nonpreferred provider who is a physician shall provide a copy of the disclosure set forth in §B of this regulation to each insured before performing a health care service for the insured in order to qualify for an assignment of benefits under a preferred provider insurance policy.
B. The disclosure text required by §A of this regulation shall be printed in at least 12 point type and shall read as follows:
"* Your doctor's charge may be higher than the amount your health insurer will pay and, if so, you may be required to pay the difference; and
"* Your coinsurance, deductible and out-of-pocket maximum may be higher because your doctor is not in your health insurer's network.
"* An estimate of the cost of the services;
"* Any payment terms that apply; and
"* Whether your doctor will charge you interest on any unpaid balance, and the amount of the interest, if any.
