1. Every health care provider and health carrier that conducts business in this state shall use standardized information for referrals. As used in this section, the terms “health care provider” and “health carrier” shall have the meaning given to such terms in section 376.1350.

2. The referral information shall contain the following:

Terms Used In Missouri Laws 376.1403

  • following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020
  • State: when applied to any of the United States, includes the District of Columbia and the territories, and the words "United States" includes such district and territories. See Missouri Laws 1.020

(1) The name of the insured;

(2) The name, address and phone number of the health carrier;

(3) The identification number and group number of the insured;

(4) The type of referral;

(5) The name, address and phone number of the health care provider referring the insured;

(6) The name, address and phone number of the health care provider to whom the insured was referred to;

(7) The number of visits requested and authorized; and

(8) The health carrier’s authorization number.

3. All health care providers and health carriers shall use the standardized referral information after January 1, 2002.

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