048-8 Wyo. Code R. § 8-10
The Department shall:
(a) Obtain and review the information required by Sections 9(b) and (c) of this Chapter;
(b) Determine whether the admission met or meets the medical necessity criteria.
(c) Inform the attending physician and the hospital of the determination, in writing as required by the Department, by the end of the next working day after the determination;
(d) Mail a written notice of the admission certification determination to the attending physician and the hospital;
(e) Determine that all diagnosis and procedure coding satisfies ICD and CPT;
(f) Determine if the admission of a retroactively eligible client met the medical necessity criteria;
(g) Provide for an appeal of denial of certification;
(h) Recruit and coordinate the work of the physician advisers;
(i) Notify the attending physician and the person responsible for the hospitals utilization review in writing or as required by the Department, of an appeal decision by the end of the next working day after the decision; and
(j) Mail a written notice of the appeal decision to the attending physician and the hospital.
048-8 Wyo. Code R. § 8-10
Amended, Eff. 1/6/2015.