Common use of Expedited Appeals Clause in Contracts

Expedited Appeals. An expedited appeal determination may be provided to the appealing party by telephone or electronic transmission and shall be followed with a letter within three (3) working days of the initial telephonic or electronic notification. In a circumstance involving an Insured’s Life Threatening condition, denials of Prescription Drugs and intravenous infusions that are currently being received, or if our internal appeal process timelines are not met, the Insured is entitled to an immediate appeal to an external review and is not required to comply with procedures for an internal review of the Adverse Determination. Timeline for Resolution

Expedited Appeals. An expedited appeal determination may be provided to the appealing party by telephone or electronic transmission and shall be followed with a letter within three (3) working days of the initial telephonic or electronic notification. In a circumstance involving an Insured’s Life Threatening condition, denials of Prescription Drugs prescription drugs and intravenous infusions that are currently being received, or if our internal appeal process timelines are not met, the Insured is entitled to an immediate appeal to an external review and is not required to comply with procedures for an internal review of the Adverse Determination. Timeline for Resolution