Which division encompasses the Managed Care Organization rules?

The Managed Care Organization rules are encompassed within Division 15. This division particularly addresses the regulatory framework governing managed care services, which includes the protocols and standards that organizations must follow to ensure compliance with state regulations. The focus of Division 15 is on the operations of managed care organizations, including their responsibilities regarding healthcare delivery, patient care protocols, and the management of health benefits.

Understanding this division is crucial for those working in claims adjustment, as it outlines the legal obligations and operational guidelines that affect how managed care organizations function. By being familiar with the specifics of Division 15, claims adjusters can better navigate the complexities of claims related to managed care systems and understand the implications of those rules on healthcare delivery.