The claims administrator has an option to defer on performing UR/IMR pending the outcome of the AOE/COE, body part dispute at which time UR/IMR can be done retrospectively
Perform UR/IMR when the RFA is originally submitted. This is what was informally previously known as "conditional UR".
In this instance, if the UR/IMR results in certifying the RFA the claims administrator must authorize the procedure if AOE/COE, body part dispute is resolved in favor of the IW. If the IW self procures the treatment the claims administrator must pay for the medical services.