Delaware: Regs focus on payment in surgery preauthorization requests
The rules clarify the surgery preauthorization requests within the utilization review process to add "the claimant's attorney of record" to the list of recipients of the utilization review determination. Surgeons certified in the health care payment system can perform surgery without seeking preauthorization. If an operating surgeon certified in the health care payment system does not preauthorize a surgery, the carrier or self-insured payer can pay the bill within 30 days or deny the bill and refer the non-preauthorized surgery to utilization review within 15 days. The rules went into effect on June 11.
Read more at the WorkersComp Forum homepage.
July 19, 2012
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