Internal claims and appeals and external review processes
Duties of insurer or private review agent performing utilization reviews — Requirement for registration — Consequences of insurer’s failure to make timely utilization review determination — Requirement that insurer or private review agent submit changes to the department — Requirement that private review agent provide timely notice of entities for whom it is providing review.
Internal claims and appeals procedures
Minimum standards of utilization review agents
Policies with prior authorization requirement provisions