Oklahoma Administrative Code (Last Updated: March 11, 2021) |
TITLE 310. Oklahoma State Department of Health |
Chapter 657. Certified Workplace Medical Plans |
Subchapter 7. Utilization Review |
SECTION 310:657-7-5. Denial of service
Latest version.
- (a) A decision to deny a service shall be clearly documented, including specific bases for the action. Confirmation shall be sent to the provider within two (2) working days after the decision. If the Plan is aware that the request for service was initiated by the injured worker, the Plan shall send written notice to the injured worker within two (2) working days after the decision.(b) A decision to deny a service after the service has been provided to an injured worker shall be issued in writing within five (5) workings days after obtaining all necessary information.(c) Written notice of a decision to deny a service shall describe the dispute resolution procedures.