Chapter 480-5-5 - UTILIZATION MANAGEMENT AND BILL SCREENING
- Section 480-5-5-.01 - Scope
- Section 480-5-5-.02 - Definitions
- Section 480-5-5-.03 - Timely Payment Of Undisputed Medical Claims
- Section 480-5-5-.04 - Statement of Services
- Section 480-5-5-.05 - Entity Qualified to Perform Bill Screening
- Section 480-5-5-.06 - Utilization Review Entity Qualified To Perform Utilization Review
- Section 480-5-5-.07 - Utilization Review Process
- Section 480-5-5-.08 - Pre-Certification Required
- Section 480-5-5-.09 - Procedures of Pre-Certification
- Section 480-5-5-.10 - Continued Stay Review Procedures
- Section 480-5-5-.11 - Technical Considerations For Review (Bill Screening) Of Claims
- Section 480-5-5-.12 - Physician Of Record
- Section 480-5-5-.13 - Emergency Care
- Section 480-5-5-.14 - Second Or Opposing Surgical Opinion
- Section 480-5-5-.15 - Bill Screening
- Section 480-5-5-.16 - Conflict Of Interest: Health Facility Owner-Ship By A Provider
- Section 480-5-5-.17 - Optometric Services
- Section 480-5-5-.18 - Chiropractic Services
- Section 480-5-5-.19 - Physical Therapy/Occupational Therapy/Speech Therapy Services
- Section 480-5-5-.20 - Hospital Services
- Section 480-5-5-.21 - Prescribed Medications
- Section 480-5-5-.22 - Approved Standardized Medical Reimbursement Forms
- Section 480-5-5-.23 - Appeals Process For Utilization Review Bill Screening, Peer Clinical Review And Denial Or Revocation Of Utilization Review Certificate
- Section 480-5-5-.24 - Discharge Planning Procedures
- Section 480-5-5-.25 - On Site Audit
- Section 480-5-5-.26 - Ambulatory Surgery Centers
- Section 480-5-5-.27 - Admission Review Procedures
- Section 480-5-5-.28 - Dental Services
- Section 480-5-5-.29 - Medical Case Management
- Section 480-5-5-.30 - Home Health Care Service
- Section 480-5-5-.31 - Pain Management Program
- Section 480-5-5-.32 - Durable Medical Equipment
- Section 480-5-5-.33 - Time Limits For Claims Payments
- Section 480-5-5-.34 - Ambulance Services
- Section 480-5-5-.35 - Impairment Rating Guide
- Section 480-5-5-.36 - Time Limits For Employee Filing Incurred Expense Claims
- Section 480-5-5-.37 - Out-Of-State Medical Providers