Common use of Appeals Procedures Clause in Contracts

Appeals Procedures. The HPN Appeals Procedures are available to you in the event you are dissatisfied with some aspect of the Plan administration or you wish to appeal an Adverse Benefit Determination. This procedure does not apply to any problem of misunderstanding or misinformation that can be promptly resolved by the Plan supplying the Member with the appropriate information. If a Member’s Plan is governed by XXXXX, the Member must exhaust the mandatory level of mandatory appeal before bringing a claim in court for a Claim of Benefits. Concerns about medical services are best handled at the medical service site level before being brought to HPN. If a Member contacts HPN regarding an issue related to the medical service site and has not attempted to work with the site staff, the Member may be directed to that site to try to solve the problem there, if the issue is not a Claim for Benefits. Please see the Glossary Terms Section herein for a description of the terms used in this section. The following Appeals Procedures will be followed if the medical service site matter cannot be resolved at the site or if the concern involves the Adverse Benefit Determination of a Claim for Benefits. All Appeals will be adjudicated in a manner designed to ensure independence and impartiality on the part of the persons making the decision.

Appeals Procedures. The HPN SHL Appeals Procedures are available to you in the event you are dissatisfied with some aspect of the Plan administration or you wish to appeal an Adverse Benefit Determination. This procedure does not apply to any problem of misunderstanding or misinformation that can be promptly resolved by the Plan supplying the Member Insured with the appropriate information. If a Memberan Insured’s Plan is governed by XXXXXERISA, the Member Insured must exhaust the mandatory level of mandatory appeal before bringing a claim in court for a Claim of Benefits. Concerns about medical services are best handled at the medical service site level before being brought to HPNSHL. If a Member an Insured contacts HPN SHL regarding an issue related to the medical service site and has not attempted to work with the site staff, the Member Insured may be directed to that site to try to solve the problem there, if the issue is not a Claim for Benefits. Please see the Glossary Terms Section herein for a description of the terms used in this section. The following Appeals Procedures will be followed if the medical service site matter cannot be resolved at the site or if the concern involves the Adverse Benefit Determination of a Claim for Benefits. All Appeals will be adjudicated in a manner designed to ensure independence and impartiality on the part of the persons making the decision.

Appeals Procedures. The HPN Appeals Procedures are available to you in the event you are dissatisfied with some aspect of the Plan administration or you wish to appeal an Adverse Benefit Determination. , This procedure does not apply to any problem of misunderstanding or misinformation that can be promptly resolved by the Plan supplying the Member with the appropriate information. If a Member’s Plan is governed by XXXXX, the Member must exhaust the mandatory level of mandatory appeal before bringing a claim in court for a Claim of Benefits. Concerns about medical services are best handled at the medical service site level before being brought to HPN. If a Member contacts HPN regarding an issue related to the medical service site and has not attempted to work with the site staff, the Member may be directed to that site to try to solve the problem there, if the issue is not a Claim for Benefits. Please see the Glossary Terms Section herein for a description of the terms used in this section. The following Appeals Procedures will be followed if the medical service site matter cannot be resolved at the site or if the concern involves the Adverse Benefit Determination of a Claim for Benefits. All Appeals will be adjudicated in a manner designed to ensure independence and impartiality on the part of the persons making the decision.

Appeals Procedures. The HPN SHL Appeals Procedures are available to you in the event you are dissatisfied with some aspect of the Plan administration or you wish to appeal an Adverse Benefit Determination. This procedure does not apply to any problem of misunderstanding or misinformation that can be promptly resolved by the Plan supplying the Member Insured with the appropriate information. If a Memberan Insured’s Plan is governed by XXXXXERISA, the Member Insured must exhaust the mandatory level of mandatory appeal before bringing a claim in court for a Claim of Benefits. Concerns about medical services are best handled at the medical service site level before being brought to HPNSHL. If a Member an Insured contacts HPN SHL regarding an issue related to the medical service site and has not attempted to work with the site staff, the Member Insured may be directed to that site to try to solve the problem there, if the issue is not a Claim for Benefits. Please see the Glossary Terms Section herein for a description of the terms used in this section. The following Appeals Procedures will be followed if the medical service site matter cannot be resolved at the site or if the concern involves the Adverse Benefit Determination of a Claim for Benefits. All Appeals will be adjudicated in a manner designed to ensure independence and impartiality on the part of the persons making the decision.

Appeals Procedures. The HPN Appeals Procedures are available to you in the event you are dissatisfied with some aspect of the Plan administration or you wish to appeal an Adverse Benefit Determination. This procedure does not apply to any problem of misunderstanding or misinformation that can be promptly resolved by the Plan supplying the Member with the appropriate information. If a Member’s Plan is governed by XXXXX, the Member must exhaust the mandatory level of mandatory appeal before bringing a claim in court for a Claim of Benefits. Concerns about medical services are best handled at the medical service site level before being brought to HPN. If a Member contacts HPN regarding an issue related to the medical service site and has not attempted to work with the site staff, the Member may be directed to that site to try to solve the problem there, if the issue is not a Claim for Benefits. Please see the Glossary Terms Section herein for a description of the terms used in this section. The following Appeals Procedures will be followed if the medical service site matter cannot be resolved at the site or if the concern involves the Adverse Benefit Determination of a Claim for Benefits. All Appeals will be adjudicated in a manner designed to ensure independence and impartiality on the part of the persons making the decision.

Appeals Procedures. The HPN Appeals Procedures are available to you in the event you are dissatisfied with some aspect of the Plan administration or you wish to appeal an Adverse Benefit Determination. This procedure does not apply to any problem of misunderstanding or misinformation that can be promptly resolved by the Plan supplying the Member with the appropriate information. If a Member’s Plan is governed by XXXXXERISA, the Member must exhaust the mandatory level of mandatory appeal before bringing a claim in court for a Claim of Benefits. Concerns about medical services are best handled at the medical service site level before being brought to HPN. If a Member contacts HPN regarding an issue related to the medical service site and has not attempted to work with the site staff, the Member may be directed to that site to try to solve the problem there, if the issue is not a Claim for Benefits. Please see the Glossary Terms Section herein for a description of the terms used in this section. The following Appeals Procedures will be followed if the medical service site matter cannot be resolved at the site or if the concern involves the Adverse Benefit Determination of a Claim for Benefits. All Appeals will be adjudicated in a manner designed to ensure independence and impartiality on the part of the persons making the decision.