ARSD 67:45:02:11 – Utilization review. | Midpage

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Administrative Rules of South Dakota

Chapter 67:45:02

§ 67:45:02:11

ARSD 67:45:02:11

Utilization review.

Effective Aug 17, 199522 SDR 16Source: 18 SDR 67, effective October 13, 1991; 22 SDR 16, effective August 17, 1995. | General Authority: SDCL 28-6-1. | Law Implemented: SDCL 28-6-1.

Claims and payments for nursing facility care, adult foster care, or assisted living are subject to review on the following levels:

(1) At the time of admission;
(2) Computerized claims review and audit; and
(3) Annual care classification review.

Source: 18 SDR 67, effective October 13, 1991; 22 SDR 16, effective August 17, 1995.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.