Section .0900 - Utilization Review | Midpage

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North Carolina Administrative Code

§ 0900

Section .0900 - Utilization Review

.0901Organizational Structure .0902Definitions .0903Application to and Compliance by Payers .0904Requirements for Utilization Review .0905Utilization Review Plan .0906Minimum Standards for Utilization Review Entities .0907Accessibility .0908Standard Data Elements .0909Medical Criteria .0910Noncertification .0911Emergencies; Waivers; Extensions; Confidentiality .0912Education of Insureds About Review Requirements .0913Identification Cards, Certificates, and Booklets .0914Appeals of Noncertification .0915Records; Examinations; Telephone Audits .0916Prohibited Acts .0917Report on Utilization Review Experience .0918Written Utilization Review Plan .0919Telephone Accessibility Standards