Sec. 13. To provide documentation demonstrating that a utilization review agent is capable of satisfying the requirement of section 11(7) of this chapter, as required by section 9(b)(3) of this chapter, the utilization review agent may provide a signed statement of a physician employed by or under contract to the utilization review agent verifying that determinations made by the utilization review agent as to the necessity or appropriateness of admissions, services, and procedures are reviewed by a physician or determined in accordance with standards or guidelines approved by a physician.
As added by P.L.128-1992, SEC.1.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 17. Health Care Utilization Review
27-8-17-1. "Covered Individual" Defined
27-8-17-2. "Department" Defined
27-8-17-4. "Health Maintenance Organization" Defined
27-8-17-5. "Provider of Record" Defined
27-8-17-6. "Utilization Review" Defined
27-8-17-7. "Utilization Review Agent" Defined
27-8-17-8. "Utilization Review Determination" Defined
27-8-17-9. Certificate of Registration; Issuance to Agent
27-8-17-10. Certificate of Registration; Renewal; Transfer; Notice of Change in Information
27-8-17-11. Minimum Utilization Review Agent Requirements
27-8-17-13. Physician's Statement; Documentation of Review Agent Capability
27-8-17-16. Fraudulent or Misleading Information; Penalties
27-8-17-18. Confidential Information