§ 9770. Definitions.
8 CA ADC § 9770Barclays Official California Code of Regulations
8 CCR § 9770
§ 9770. Definitions.
(b) “Claims Administrator” means a self-administered insurer providing security for the payment of compensation required by Divisions 4 and 4.5 of the Labor Code, a self-administered self-insured employer, or a third-party claims administrator for a self-insured employer, insurer, legally uninsured employer, or joint powers authority.
Financing Administration. Washington DC: Superintendent of Documents, and updated successor revised manuals.
(n) “Standard Industrial Classification code” means the 4 digit number which identifies the primary type of economic activity which the employer is engaged in that corresponds to the numeric classifications and descriptions listed in The Standard Industrial Classification Manual 1987, Office of Management and Budget, Washington DC: Superintendent of Documents, US Government Printing Office, 1989, and updated successor revised manuals.
(p) “Utilization review” or “Utilization Management” is the system used to manage, assess, improve, or review patient care and decision-making through case by case assessments of the medical reasonableness or medical necessity of the frequency, duration, level and appropriateness of medical care and services, based upon professionally recognized standards of care. Utilization review may include, but is not limited to, prospective, concurrent, and retrospective review of a request for authorization of medical treatment.
Credits
Note: Authority cited: Sections 133, 4600.5, 4603.5 and 5307.3, Labor Code. Reference: Sections 3300, 4061.5, 4600.5, 5400, 5401 and 5402, Labor Code.
History
1. New article 4 and section filed 12-31-93; operative 1-1-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 93, No. 53). For prior history, see Register 84, No. 35.
2. New subsection (h) and subsection relettering filed 2-14-96; operative 2-14-96. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 96, No. 7).
3. Repealer of subsection (g) and subsection relettering filed 9-21-2015; operative 10-1-2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 39).
This database is current through 6/14/24 Register 2024, No. 24.
Cal. Admin. Code tit. 8, § 9770, 8 CA ADC § 9770
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