S.D. Admin. R. 67:16:03:10

Current through Register Vol. 50, page 162, June 24, 2024

Section 67:16:03:10 - Utilization review

The department may review inpatient hospital service claims for the following information:

(1) Necessity of admission;

(2) Length of stay;

(3) Coding;

(4) Computerized claims processing;

(5) Post-payment review; and

(6) Peer review.

S.D. Admin. R. 67:16:03:10

SL 1975, ch 16, § 1; 1 SDR 30, effective 10/13/1974; 7 SDR 66, 7 SDR 89, effective 7/1/1981; 15 SDR 2, effective 7/17/1988; 16 SDR 235, effective 7/5/1990.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.