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Michigan Administrative Code (Last Updated: November 16, 2016) |
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Department LR. Licensing and Regulatory Affairs |
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Workers Compensation Agency |
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Chapter Workers' Compensation Health Care Services Rules |
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Part 12. Carrier's professional health care review program R 418.101201 Carrier's health care review program. |
Section 418.101206. Certification of professional health care review program.
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(1) The workers' compensation agency shall certify the carrier's professional health care review program.
(2) A carrier, or the reviewing entity on behalf of the carrier, shall apply to the agency for certification of a carrier's professional health care review program in the manner prescribed by the workers' compensation agency.
(3) A carrier shall receive certification if the carrier or the carrier's review company provides to the agency a description of its professional health care review program and includes all of the information specified in R 418.101204. The workers' compensation agency shall send a copy of the certification of the carrier's review program to the carrier.
(4) The carrier shall submit a copy of "The Carriers Explanation of Benefits" form utilized to notify providers of payment decisions.
History: 2000 AACS; 2003 AACS; 2005 AACS; 2010 AACS.