QIO REVIEW FUNCTIONS
- Section 476.83 - Initial denial determinations
- Section 476.84 - Changes as a result of DRG validation
- Section 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations
- Section 476.86 - Correlation of Title XI functions with Title XVIII functions
- Section 476.88 - Examination of the operations and records of health care facilities and practitioners
- Section 476.90 - Lack of cooperation by a provider or practitioner
- Section 476.93 - Opportunity to discuss proposed initial denial determination and changes as a result of a DRG validation
- Section 476.94 - Notice of QIO initial denial determination and changes as a result of a DRG validation
- Section 476.96 - Review period and reopening of initial denial determinations and changes as a result of DRG validations
- Section 476.98 - Reviewer qualifications and participation
- Section 476.100 - Use of norms and criteria
- Section 476.102 - Involvement of health care practitioners other than physicians
- Section 476.104 - Coordination of activities
- Section 476.110 - Use of immediate advocacy to resolve oral beneficiary complaints
- Section 476.120 - Submission of written beneficiary complaints
- Section 476.130 - Beneficiary complaint review procedures
- Section 476.140 - Beneficiary complaint reconsideration procedures
- Section 476.150 - Abandoned complaints and reopening rights
- Section 476.160 - General quality of care review procedures
- Section 476.170 - General quality of care reconsideration procedures