Provider's Statement; Documentation of Review Agent Capability

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Sec. 9. To provide documentation demonstrating that a claim review agent is capable of satisfying the requirement of section 7(6) of this chapter, the claim review agent must provide a signed statement of a provider employed by the claim review agent verifying that determinations are:

(1) made by; or

(2) determined in accordance with standards or guidelines approved by;

a provider licensed in the same discipline as the provider who rendered the service.

As added by P.L.128-1992, SEC.2.


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