§ 26-55-105 — Consultation after issuing an adverse determination

After issuing an adverse determination, the health insurer or
contracted utilization review entity shall provide the
opportunity to the health care provider to discuss the medical
necessity of the health care service with the person who has
decision making authority and will be responsible for
determining authorization of the health care service under
review. The health insurer or contract utilization review
entity shall attempt to schedule the discussion within five (5)
business days after the health care provider's request.