Pennsylvania Code
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COMMONWEALTH OF PENNSYLVANIA

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34 Pa. Code § 127.616. Duties of reviewers—consultation with provider under review.

§ 127.616. Duties of reviewers—consultation with provider under review.

 The PRO shall give the provider under review written notice of the opportunity to discuss treatment decisions with the reviewer. The reviewer shall initiate discussions with the provider under review when such a discussion will assist the reviewer in reaching a determination. If the provider under review declines to discuss treatment decisions with the reviewer, a determination shall be made in the absence of such a discussion.


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