Contractor Notice to Enrollees. a) Contractor must issue a written Notice of Adverse Determination and Fair Hearing Rights to any Enrollee: i) When Contractor or its utilization review agent has denied a request to approve a Benefit Package service ordered by an MCO provider; or
Appears in 7 contracts
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Contractor Notice to Enrollees. a) Contractor must issue a written Notice of Adverse Determination and Fair Hearing Rights to any Enrollee:
i) When Contractor or its utilization review agent has denied a request to approve a Benefit Package service ordered by an MCO provider; or
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Contractor Notice to Enrollees. a) Contractor must issue a written Notice of Adverse Determination and Fair Hearing Rights to any Enrollee:
i) When Contractor or its utilization review agent has denied a request to approve a Benefit Package service ordered by an MCO provider; , or
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Amerigroup Corp)
