Rule 120-2-111-.08 - Independent Review Organization Telephone Access(1) An independent review organization shall have appropriate personnel reasonably available by telephone, in accordance with Eastern Standard or Eastern Daylight time, whichever is applicable, at least forty (40) hours per week during normal business hours, to discuss eligible enrollee's care and to allow response to telephone questions. The independent review organization must also allow reasonable telephone access on evenings and weekends.(2) An independent review organization must have a telephone system capable of accepting or recording or providing instructions to incoming calls during other than normal business hours and shall respond to such calls not later than two working days of the later of the date on which the call was received or the date the details necessary to respond have been received from the caller. The independent review organization shall request the specific information needed from the caller not later than two working days after initial receipt of the call in question. In the event of an emergency, the independent review organization shall respond within the time appropriate to circumstances relating to the delivery of the services and the condition of the eligible enrollee.Ga. Comp. R. & Regs. R. 120-2-111-.08
O.C.G.A. §§ 33-2-9, 33-20A-41.
Original Rule entitled "Independent Review Organization Telephone Access" adopted. F. Sept. 20, 2023; eff. August 1, 2023, as specified by the Agency.