Appeal of a Pre-Service Claim. A Claimant may appeal an Adverse Benefit Determination with respect to a Pre-Service Claim within 365 days of receiving the Adverse Benefit Determination. 1) AvMed shall notify the Claimant of its determination on review not later than 30 days after XxXxx receives the Claimant’s request. An appeal of an Adverse Benefit Determination with respect to a Pre-Service Claim may be submitted to: AvMed Member Relations P.O. Box 749 Gainesville, Florida 32627 Telephone: 0-000-000-0000 Fax: (000) 000-0000
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Samples: Medical and Hospital Service Contract, Large Group Choice Plan Medical and Hospital Service Contract, Medical and Hospital Service Contract
Appeal of a Pre-Service Claim. A Claimant may appeal an Adverse Benefit Determination with respect to a Pre-Service Claim within 365 days of receiving the Adverse Benefit Determination.
1) AvMed shall notify the Claimant of its determination on review not later than 30 days after XxXxx receives the Claimant’s requestrequest . An appeal of an Adverse Benefit Determination with respect to a Pre-Service Claim may be submitted to: AvMed Member Relations P.O. Box 749 Gainesville, Florida 32627 Telephone: 0-000-000-0000 Fax: (000) 000-0000
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