(1) As used in this section, “insurer” means an insurance company, a health maintenance organization, a hospital and medical service corporation, or a self-insured health plan for employees of a governmental entity that provides dental benefits.
(2) As used in this section, “insurer” includes an outside review entity that contracts with an insurance company, a health maintenance organization, a hospital and medical service corporation, or a self-insured health plan for employees of a governmental entity that provides dental benefits.
(3) A denial of all or part of a dental claim based upon medical necessity shall be made by a dentist licensed in the United States who is a graduate of a Commission on Dental Accreditation accredited program.
(4) To facilitate expeditious resolution, the insurer shall provide, upon request, a written communication to the treating dentist with the name, state where licensed, license number, and direct telephone number of the reviewing dentist.