EXTERNAL REVIEW OF ADVERSE DETERMINATION
- 695G.241 - Adverse determination deemed final for purpose of submitting to external review organization.
- 695G.251 - Request for review; assignment of external review organization; provision of documents relating to adverse determination to external review organization.
- 695G.261 - Review of documents by external review organization; decision of external review organization.
- 695G.271 - Expedited approval or denial of request.
- 695G.280 - Basis for decision of external review organization.
- 695G.290 - Decision in favor of insured binding on managed care organization; limitation of liability; cost for external review organization.
- 695G.300 - Submission of complaint of insured to external review organization.
- 695G.310 - Annual report; requirements.