| (a) Identification of URAs. If a URA's staff member
is conducting an on-site or off-site review, each staff member must
provide his or her name, the name of his or her organization, photo
identification, and the URA identification card with the certification
or registration number assigned by TDI when requested by an individual,
including an enrollee or health care provider.
(b) On-site review. For on-site review conducted at
a health care facility, URAs:
(1) must ensure that their on-site review staff:
(A) register with the appropriate contact individual,
if available, prior to requesting any clinical information or assistance
from health care facility staff; and
(B) wear appropriate health care facility supplied
identification tags while on the health care facility premises;
(2) must agree, if so requested, that the medical records
remain available in the designated areas during the on-site review
and that reasonable health care facility administrative procedures
will be followed by on-site review staff to avoid disrupting health
care facility operations or enrollee care. The procedures, however,
should not obstruct or limit the ability of the URA to efficiently
conduct the necessary review.
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