Common use of Column Label Description Clause in Contracts

Column Label Description. Member: Beginning Balance Total number of outstanding appeals at the beginning of the first day of the reporting period. Member: Ending Balance Total number of outstanding appeals at the end of the last day of the reporting period. Member: Received: Total Total number of appeals received during the reporting period. Member: Received: Expedited Total number of expedited appeals received within the reporting period broken down by Oral and Written. Member: Received: Expedited: Oral Total number of expedited oral appeals received within the reporting period. Member: Received: Expedited: Written Total number of expedited written appeals received within the reporting period. Member: Received: Non Expedited Total number of non-expedited appeals received within the reporting period broken down by Oral and Written. Member: Received: Non Expedited: Oral Total number of non-expedited oral appeals received within the reporting period. Member: Received: Non Expedited: Written Total number of non-expedited written appeals received within the reporting period. Member: Received: Non Expedited: 5 Working Days Written Notice Provided Total number of written notices provided within five (5) working days for non- expedited appeals. Member: Resolved: Total Total number of appeals resolved during the reporting period. Member: Resolved: Expedited Resolved in 3 Working Days Total of expedited appeals resolved in three (3) or fewer working days. Member: Resolved: Non Expedited Resolved in 30 Calendar Days Total of non-expedited appeals resolved in thirty (30) or fewer calendar days. Member: Resolved: Non Expedited Average Days for Resolution Average number of days to resolve all non-expedited appeals excluding non- expedited appeals extended by fourteen (14) calendar days. Member: Resolved: Written Notice of Resolution within 30 Calendar Days Total number of written notice of resolution that were provided within thirty (30) calendar days of receipt of a non-expedited appeal. Member: Resolved: Expedited An appeal that is required to be resolved within three (3) calendar days). Member: Resolved: Final Disposition Result of the expedited or non-expedited appeal process broken down by upheld, overturned and partially overturned. Member: Resolved: Expedited: Final Disposition: Upheld Total number of expedited appeals that were resolved during the reporting period and were upheld. Upheld means that the prior decision was confirmed and remains as is. Member: Resolved: Expedited: Final disposition: Overturned Total number of expedited appeals that were resolved during the reporting period and were overturned. Overturned means that the prior decision was not confirmed and was reversed. Member: resolved: Expedited: Final disposition: Partially Overturned Total number of expedited appeals that were resolved during the reporting period and were partially overturned. Partially overturned means that part of the prior decision was not confirmed and was reversed. Member: Resolved: Expedited: Moved to Non Expedited Number of expedited appeals that moved to a non-expedited appeal process. Member: Resolved: Non Expedited: Oral Abandoned A non-expedited appeal that was not followed up by a written appeal and no additional action was taken.

Column Label Description. Member: Beginning Balance Total number of outstanding appeals at the beginning of the first day of the reporting period. Member: Ending Balance Total number of outstanding appeals at the end of the last day of the reporting period. Member: Received: Total Total number of appeals received during the reporting period. Member: Received: Expedited Total number of expedited appeals received within the reporting period broken down by Oral and Written. Member: Received: Expedited: Oral Total number of expedited oral appeals received within the reporting period. Member: Received: Expedited: Written Total number of expedited written appeals received within the reporting period. Member: Received: Non Expedited Total number of non-expedited appeals received within the reporting period broken down by Oral and Written. Member: Received: Non Expedited: Oral Total number of non-expedited oral appeals received within the reporting period. Member: Received: Non Expedited: Written Total number of non-expedited written appeals received within the reporting period. Member: Received: Non Expedited: 5 Working Days Written Notice Provided Total number of written notices provided within five (5) working days for non- expedited appeals. Member: Resolved: Total Total number of appeals resolved during the reporting period. Member: Resolved: Expedited Resolved in 3 Working Days Total of expedited appeals resolved in three (3) or fewer working days. Member: Resolved: Non Expedited Resolved in 30 Calendar Days Total of non-expedited appeals resolved in thirty (30) or fewer calendar days. Member: Resolved: Non Expedited Average Days for Resolution Average number of days to resolve all non-expedited appeals excluding non- Average Days for Resolution expedited appeals extended by fourteen (14) calendar days. Member: Resolved: Written Notice of Resolution within 30 Calendar Days Total number of written notice of resolution that were provided within thirty (30) calendar days of receipt of a non-expedited appeal. Member: Resolved: Expedited An appeal that is required to be resolved within three (3) calendar days). Member: Resolved: Final Disposition Result of the expedited or non-expedited appeal process broken down by upheld, overturned and partially overturned. Member: Resolved: Expedited: Final Disposition: Upheld Total number of expedited appeals that were resolved during the reporting period and were upheld. Upheld means that the prior decision was confirmed and remains as is. Member: Resolved: Expedited: Final disposition: Overturned Total number of expedited appeals that were resolved during the reporting period and were overturned. Overturned means that the prior decision was not confirmed and was reversed. Member: resolved: Expedited: Final disposition: Partially Overturned Total number of expedited appeals that were resolved during the reporting period and were partially overturned. Partially overturned means that part of the prior decision was not confirmed and was reversed. Member: Resolved: Expedited: Moved to Non Expedited Number of expedited appeals that moved to a non-expedited appeal process. Member: Resolved: Non Expedited: Oral Abandoned A non-expedited appeal that was not followed up by a written appeal and no additional action was taken.

Column Label Description. Member: Beginning Balance Total number of outstanding appeals at the beginning of the first day of the reporting period. Member: Ending Balance Total number of outstanding appeals at the end of the last day of the reporting period. Member: Received: Total Total number of appeals received during the reporting period. Member: Received: Expedited Total number of expedited appeals received within the reporting period broken down by Oral and Written. Member: Received: Expedited: Oral Total number of expedited oral appeals received within the reporting period. Member: Received: Expedited: Written Total number of expedited written appeals received within the reporting period. Member: Received: Non Expedited Total number of non-non expedited appeals received within the reporting period broken down by Oral and Written. Member: Received: Non Expedited: Oral Total number of non-non expedited oral appeals received within the reporting period. Member: Received: Non Expedited: Written Total number of non-non expedited written appeals received within the reporting period. Member: Received: Non Expedited: 5 Working Days Written Notice Provided Total number of written notices provided within five (5) working days for non- non-expedited appeals. Member: Resolved: Total Total number of appeals resolved during the reporting period. Member: Resolved: Expedited % Resolved in 3 Working Days Total percentage of expedited appeals resolved in three (3) or fewer working days. Member: Resolved: Non Expedited % Resolved in 30 Calendar Days Total percentage of non-non expedited appeals resolved in thirty (30) or fewer calendar days. Member: Resolved: Non Expedited Average Days for Resolution Average number of days to resolve all non-non expedited appeals excluding non- non expedited appeals extended by fourteen (14) calendar days. Member: Resolved: Written Notice of Resolution within 30 Calendar Days Total number of written notice of resolution that were provided within thirty (30) calendar days of receipt of a non-non expedited appeal. Member: Resolved: Expedited An appeal that is required to be resolved within three (3) calendar days). Member: Resolved: Final Disposition Result of the expedited or non-non expedited appeal process broken down by upheld, overturned and partially overturned. Member: Resolved: Expedited: Final Disposition: Upheld Total number of expedited appeals that were resolved during the reporting period and were upheld. Upheld means that the prior decision was August 28, 2013 MCO Reports Description Page | 100 confirmed and remains as is. Member: Resolved: Expedited: Final disposition: Overturned Total number of expedited appeals that were resolved during the reporting period and were overturned. Overturned means that the prior decision was not confirmed and was reversed. Member: resolved: Expedited: Final disposition: Partially Overturned Total number of expedited appeals that were resolved during the reporting period and were partially overturned. Partially overturned means that part of the prior decision was not confirmed and was reversed. Member: Resolved: Expedited: Moved to Non Expedited Number of expedited appeals that moved to a non-non expedited appeal process. Member: Resolved: Non Expedited: Oral Abandoned A non-non expedited appeal that was not followed up by a written appeal and no additional action was taken.