(a) If a utilization review entity requires prior authorization of a nonurgent healthcare service, the utilization review entity shall make an authorization or adverse determination and notify the subscriber and the subscriber's nonurgent healthcare provider of the decision within two (2) business days of obtaining all necessary information to make the authorization or adverse determination.
(b) For purposes of this section, "necessary information" includes the results of any face-to-face clinical evaluation or second opinion that may be required.
Section: Previous 23-99-1102 23-99-1103 23-99-1104 23-99-1105 23-99-1106 23-99-1107 23-99-1108 23-99-1109 23-99-1110 23-99-1111 23-99-1112 23-99-1113 23-99-1114 NextLast modified: November 15, 2016