§ 67:16:05:08

ARSD 67:16:05:08

Utilization review.

Effective Jul 1, 199016 SDR 233Source: 1 SDR 30, effective October 13, 1974; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 111, effective January 7, 1990; 16 SDR 233, effective July 1, 1990. | General Authority: SDCL 28-6-1. | Law Implemented: SDCL 28-6-1.

Home health services may be reviewed on the following levels:

(1) Computerized claims processing;
(2) Cost comparison to institutional care; and
(3) Postpayment review.

Source: 1 SDR 30, effective October 13, 1974; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 111, effective January 7, 1990; 16 SDR 233, effective July 1, 1990.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.