{"data":{"id":"us-ky/krs-304.17c-137","jurisdiction":"us-ky","citation":"KRS 304.17C-137","heading":"Assignment of benefits under a dental insurance plan -- Procedures --","body":"Revocation -- Construction.\n(1) (a) An insurer providing coverage under a dental benefit plan shall honor a\nwritten assignment of benefits due under the plan that is:\n1. Made:\na. By a covered person to a provider for dental services provided to\nthe covered person; and\nb. On a form established by the commissioner in an administrative\nregulation promulgated in accordance with KRS Chapter 13A and\nsubsection (2) of this section; and\n2. Signed by the covered person and the provider.\n(b) A provider with a valid assignment under paragraph (a) of this subsection\nshall provide the following to the insurer when submitting a request for\npayment pursuant to the assignment:\n1. A copy of the dually signed assignment; and\n2. Any information or documentation necessary for verifying coverage, or\nrequired for claims processing, under the dental benefit plan.\n(c) 1. Upon a provider's compliance with paragraph (b) of this subsection, the\ninsurer shall make payments for covered serv ices directly to the\nprovider.\n2. A payment made to a provider under subparagraph 1. of this paragraph\nshall be made according to the same criteria and payment schedule\nunder which the insurer would have been required to make the payment\nto the covered per son if the benefits due under the plan had not been\nassigned.\n(2) The form established by the commissioner under subsection (1)(a)1.b. of this\nsection shall include a notice informing the covered person that:\n(a) The provider, as applicable:\n1. Is an out-of-network provider;\n2. May charge the covered person for noncovered services; and\n3. May charge the covered person for any portion of the cost of a covered\nservice that is not reimbursed under the dental benefit plan;\n(b) Any assignment of benefits is optional; and\n(c) If the covered person has accrued a credit balance on his or her account, the\nprovider shall:\n1. Notify the covered person of the credit balance with the provider within\nthirty (30) days; and\n2. a. Except as provided in subdivision b. of this  subparagraph, refund\nany credit balance that has accrued on the covered person's\naccount with the provider within thirty (30) days of receiving a\nrequest for refund from the covered person; and\nb. If, under the assignment, the provider collects payment fr om the\ncovered person and subsequently receives payment from the\ninsurer, refund the covered person within thirty (30) days of\nreceiving the payment from the insurer unless the provider and\ncovered person agree otherwise in writing.\n(3) (a) An assignment o f benefits may be revoked by the covered person, with or\nwithout the consent of the provider, by submitting the revocation, in writing,\nto the insurer.\n(b) An insurer that receives a revocation referenced in paragraph (a) of this\nsubsection shall promptly send a dated and time -stamped copy of the\nrevocation to the provider.\n(c) A revocation made in accordance with this subsection shall:\n1. Become effective when the insurer receives a copy of the revocation;\nand\n2. Only be effective for any charges incurred on or after the effective date\nestablished under subparagraph 1. of this paragraph.\n(4) This section shall not be construed to limit an insurer's ability to:\n(a) Determine the scope of a dental benefit plan's benefits, services, or other\nterms that are not in conflict with this section; or\n(b) Negotiate any contract with a health care provider regarding reimbursement\nrates or any other lawful provisions that are not in conflict with this section.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=56661","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:49Z","sha256":"981dba55185c85a23ba5b14a38c71271be242d44cb26ff966014dfacf9b0d7ef","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17c-136","next":"us-ky/krs-304.17c-138"},"notice":"GroundRules: Original legal text. Not legal advice."}