58-17H-46. Concurrent review urgent care requests--Extended care requests--Time for determination and notice.
151 words·~1 min read·
/sd/title-58/chapter-58-17/58-17h-46·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
For concurrent review urgent care requests involving a request by the covered person or the covered person's authorized representative to extend the course of treatment beyond the initial period of time or the number of treatments, if the request is made at least twenty-four hours prior to the expiration of the prescribed period of time or number of treatments, the health carrier shall make a determination with respect to the request and notify the covered person or, if applicable, the covered person's authorized representative, of the determination, whether it is an adverse determination or not, as soon as possible, taking into account the covered person's medical condition but in no event more than twenty-four hours after the date of the health carrier's receipt of the request.
If the health carrier's determination is an adverse determination, the health carrier shall provide notice of the adverse determination in accordance with § 58-17H-48 .