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At a Glance:
Utilization Review

§ 42.137

Utilization Review

(a) The claimant and the carrier may jointly request the board for an informal review and determination of the necessity or proposed medical treatment.

(b) The application shall be accompanied by supporting documentation from one or more health care providers.

(c) The determination of necessity shall be informal, for the purpose of resolving disputes, and shall not be binding on either party.

(d) The carrier shall bear the cost of a review provided under this section.

The provisions of this § 42.137 adopted to be effective January 1, 1990, 14 TexReg 6671.

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