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Utilization Management and Bill Screening | Midpage
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Alabama Administrative Code
480
Chapter 480-5-5
Utilization Management and Bill Screening
Alabama Department of Workforce (formerly Alabama Department of Labor)
480-5-5-.01
Scope
480-5-5-.02
Definitions
480-5-5-.03
Timely Payment Of Undisputed Medical Claims
480-5-5-.04
Statement Of Services
480-5-5-.05
Entity Qualified To Perform Bill Screening
480-5-5-.06
Utilization Review Entity Qualified To Perform Utilization Review
480-5-5-.07
Utilization Review Process
480-5-5-.08
Pre-Certification Required
480-5-5-.09
Procedure For Pre-Certification
480-5-5-.10
Continued Stay Review Procedures
480-5-5-.11
Technical Considerations For Review (Bill Screening) Of Claims
480-5-5-.12
Physician Of Record
480-5-5-.13
Emergency Care
480-5-5-.14
Second Or Opposing Surgical Opinion
480-5-5-.15
Bill Screening
480-5-5-.16
Conflict Of Interest: Health Facility Owner-Ship By A Provider
480-5-5-.17
Optometric Services
480-5-5-.18
Chiropractic Services
480-5-5-.19
Physical Therapy/Occupational Therapy/Speech Therapy Services
480-5-5-.20
Hospital Services
480-5-5-.21
Prescribed Medications
480-5-5-.22
Approved Standardized Medical Reimbursement Forms
480-5-5-.23
Appeals Process For Utilization Review Bill Screening, Peer Clinical Review And Denial Or Revocation Of Utilization Review Certificate
480-5-5-.24
Discharge Planning Procedures
480-5-5-.25
On Site Audit
480-5-5-.26
Ambulatory Surgery Centers
480-5-5-.27
Admission Review Procedures
480-5-5-.28
Dental Services
480-5-5-.29
Medical Case Management
480-5-5-.30
Home Health Care Service
480-5-5-.31
Pain Management Program
480-5-5-.32
Durable Medical Equipment
480-5-5-.33
Time Limits For Claims Payments
480-5-5-.34
Ambulance Services
480-5-5-.35
Impairment Rating Guide
480-5-5-.36
Time Limits For Employee Filing Incurred Expense Claims
480-5-5-.37
Out-Of-State Medical Providers