Utilization Standards/Medical Billing Disputes
What are Utilization Standards?
This rule includes terminology, administrative procedures and dispute resolution procedures to implement the Division’s Medical Treatment Guidelines and Medical Fee Schedule. To view Rule 16, please click here.
Medical Billing Disputes
The Division’s Medical Dispute Resolution Unit is available to resolve disputes resulting from a violation of Rules 11, 16, 17 and 18. Please contact 303-318-8765 or firstname.lastname@example.org with any questions.
- WC181 - Medical Billing Dispute Resolution Intake Form (PDF) | (Word)
- WC188 - Prior Authorization (PDF) | (Word)
- WC195 - Notification by an Authorized Treating Provider (PDF) | (Word)
- Evaluation and Management (E&M) Audit Form (PDF) | (Word)
- Desk Aid 15A - Non-medical Discharge Form Letter (PDF) | (Word)
- Desk Aid 15B - Non-medical Discharge Form Letter (Spanish) (PDF) | (Word)