Ohio Code § 3922.07

§ 3922.07.

In addition to the information provided under division (D)(1)(b) of section 3922.05 , division (B) of section 3922.08 , division (C) of section 3922.09 , and division (D) of section 3922.10 of the Revised Code , an assigned independent review organization, to the extent that such documents are

available and appropriate, shall consider all of the following when conducting its

review: (A) The covered person's medical records; (B) The attending health care professional's recommendation; (C) Consulting reports from appropriate health care professionals and other documents

submitted by the health plan issuer, covered person, or covered person's treating

provider; (D) The terms of coverage under the covered person's health benefit plan to ensure that

the independent review organization's decision is not contrary to the terms of the

plan; (E) The most appropriate practice guidelines, including evidence-based standards, and

practice guidelines developed by the federal government, and national or professional

medical societies, boards, and associations; (F) Any applicable clinical review criteria developed and used by the health plan issuer

or its designated utilization review organization; (G) The opinion of the independent review organization's clinical reviewer or reviewers

after considering the other sources described in this section.