Utilization Review

Fast-Track UR for Workers’ Comp: New Rules for Entities Conducting UR

We spent the last few weeks bringing readers up to speed on the new “automatic” authorization and “fast-track” utilization review (UR) process for workers’ comp. While we’ve ...

Authorization 2018: New Billing and RFA Deadlines

The new “fast-track” automatic authorization process took effect on January 1, 2018. Under certain circumstances, some providers may provide “automatically” authorized treatm...

Authorization: 6 Qualifying Conditions for Fast-track Automatic Authorization

On January 1, 2018, the new “fast-track” automatic authorization takes effect. In certain cases, some providers will be able to provide treatment without first submitting a R...

In Workers' Comp, Authorization Is Final

Let’s be very clear: in the workers’ comp dialect of Legalese, “authorization” means guaranteed payment for approved services. Period.While one can imagine scenarios i...

2018 Authorization/Utilization Review: Major Changes Effective 1/1/2018

Senate Bill 1160 makes significant changes to the authorization and utilization review (UR) process starting in 2018. New “fast-track” UR takes effect on January 1. Fa...

Just in Time: RFA and Utilization Review Timeframe Requirements

In California, proper authorization is one of the most important factors for compliance in workers’ comp billing and payment. Legally, “authorization” is the insurer’s accept...