§ 67:16:47:14

ARSD 67:16:47:14

Utilization review.

Effective Aug 31, 200532 SDR 33Source: 32 SDR 33, effective August 31, 2005. | General Authority: SDCL 28-6-1. | Law Implemented: SDCL 26-6-14 , 28-6-1.

The department may conduct utilization reviews on the following three levels:

(1) Computerized claims processing;
(2) Post payment review; and
(3) Peer review.

Source: 32 SDR 33, effective August 31, 2005.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 26-6-14 , 28-6-1.