23 CAR § 144-103. Definitions

(a) Unless otherwise separately defined in this part, the terms or phrases as used in this part shall follow the definitions of such terms or phrases as defined in Arkansas Code § 23-99-1103, or as later amended in the Prior Authorization Transparency Act, Arkansas Code § 23-99-1101 et seq. (b) As used in this part, "benefit inquiry" means an inquiry by an Arkansas-licensed healthcare provider to a utilization review entity related to medical necessity, coverage, or payment for prospective healthcare services, including prescription drugs, for an enrolled member of a healthcare plan of the applicable healthcare insurer for services or prescription drugs that are not subject to prior authorization requirements of the utilization review entity.