Indiana Statutes
§ 27-8-17-6 — "Utilization review" defined
(a)As used in this chapter, "utilization review"
means a system for prospective, concurrent, or retrospective review of
the medical necessity and appropriateness of health care services
provided or proposed to be provided to a covered individual.
(b)The term does not include the following:
(1)Elective requests for clarification of coverage, eligibility, or
benefits verification.
(2)Medical claims review (as defined in IC 27-8-16-4).
Free access — add to your briefcase to read the full text and ask questions with AI
Indiana § 27-8-17-6 ("Utilization review" defined) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.
Legislative History
As added by P.L.128-1992, SEC.1.
Nearby Sections
15
§ 27-1-1-1
Creation; functions§ 27-1-1-2
Insurance commissioner§ 27-1-1-3
Personnel§ 27-1-1-4
Repealed§ 27-1-1-5
Repealed§ 27-1-1.5-10
"Annual Statement Blank"§ 27-1-1.5-11
"Annual Statement Instructions"§ 27-1-1.5-12
"Current Dental Terminology"; "CDT"§ 27-1-1.5-13
"Current Procedural Terminology"; "CPT"§ 27-1-1.5-15
"Financial Analysis Handbook"§ 27-1-1.5-16
"Financial Condition Examiner's Handbook"§ 27-1-1.5-18
"Healthcare Common Procedure Coding System"; "HCPCS"