A person or entity aggrieved by the action of an insurer regarding medical fees must exhaust the dispute resolution procedure of the insurer before filing a petition or otherwise seeking relief from the department. If the aggrieved party has exhausted the dispute resolution procedure of the insurer or the insurer has failed to resolve a dispute within 30 calendar days after the dispute was submitted to the insurer, the party may petition the department for a hearing on the matter in dispute pursuant to SDCL chapter 1-26. The petition for a hearing must be mailed within 30 calendar days after written notice of the final decision of the insurer is mailed to the aggrieved party.
S.D. Admin. R. 47:03:05:06
General Authority: SDCL 62-7-8.
Law Implemented: SDCL 62-7-8.