Health Rate & Form Filing Requirements for
Managed Care
Requirements from South Dakota Codified Law (SDCL) |
|
Statute |
Topic |
| 58-17F-1 | Definitions. Terms used in this chapter mean ... |
| 58-17H-28 | Prospective review determinations--Timing--Notification of requirements- -Extension of time. |
| 58-17H-29 | Concurrent review determinations--Timing--Notification requirements. |
| 58-17H-30 | Retrospective review determinations--Timing--Notification requirements. |
| 58-17H-32 | Notification of adverse determination--Contents. |
| 58-17H-33 | Information required to be provided to covered persons and prospective covered persons. |
| 58-17H-40 | Urgent care requests--Written procedures for receipt and determination of requests required. |
| 58-17H-43 | Urgent care requests--Timely notification of determination. |
| 58-17H-41 | Insufficient information for determination--Notice and statement of necessary information required. |
| 58-17H-42 | Insufficient information for determination of prospective urgent care requests. |
| 58-17H-44 | Time within which to submit necessary information. |
| 58-17H-45 | Urgent care requests--Notice of determination--Failure to submit necessary information as grounds for denial of certification. |
| 58-17H-46 | Concurrent review urgent care requests--Extended care requests--Time for determination and notice. |
| 58-17H-47 | Calculation of time periods for determinations. |
| 58-17H-48 | Notification of adverse determinations--Requirements. |
| 58-17I-7 | Review of adverse determinations--Time for filing--Designation and notice of reviewers--Scope of review. |
| 58-17I-8 | Rights of covered person or authorized representative on review--Access to documentation. |
| 58-17I-9 | Time for decision and notice--Calculation of time periods. |
| 58-17I-11 | Issuance of decision--Required contents. |
| 58-17I-1 | Expedited review for adverse determinations involving urgent care requests--Appointment of peers for review. |
| 58-17F-13 | Transmission of necessary information for certain expedited reviews. |
| 58-17F-14 | Expedited review decision not initial determination for benefits--Notification--Time periods--Continuation of service involving concurrent review urgent care requests. |
| 58-17F-15 | Expedited review decision--Notification--Required contents. |
Requirements from Administrative Rules of South Dakota |
|
| 20:06:34:11 | Scope of retrospective review |
Division of Insurance
445 E. Capitol Avenue
Pierre, SD 57501
Tel. 605.773.3563
Fax. 605.773.5369
445 E. Capitol Avenue
Pierre, SD 57501
Tel. 605.773.3563
Fax. 605.773.5369
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