Current through December 10, 2024
Private review agents shall utilize the following:
1. Written clinical criteria, as needed, for the purpose of determining the Appropriateness of the certification; such criteria should be periodically evaluated and updated;2. Physician consultants or specialists who are certified by the Boards within the American Board of Medical Specialists or the American Board of Osteopathy from the major areas of clinical services;3. A formal program for orientation and training of UR staff; and4. Written documentation of an active Quality Assessment Program.15 Miss. Code. R. 16-1-82.13.5