Expedited Resolution of Appeals. General Rule The Contractor must establish and maintain an expedited review process for appeals, when the Contractor determines (for a request from the member) or the provider indicates (in making the request on the member's behalf or supporting the member's request) that taking the time for a standard resolution could seriously jeopardize the member's life or health or ability to attain, maintain, or regain maximum function.
Appears in 2 contracts
Samples: Definition of Terms and Acronyms, Contract
Expedited Resolution of Appeals. General Rule The Contractor must contractor shall establish and maintain an expedited review process for appeals, appeals when the Contractor contractor determines (for a request from the memberenrollee) or the provider indicates (in making the request on the member's enrollee’s behalf or supporting the member's enrollee’s request) that taking the time for a standard resolution could seriously jeopardize the member's enrollee’s life or health or ability to attain, maintain, maintain or regain maximum function.
Appears in 1 contract
Samples: Amerigroup Corp
Expedited Resolution of Appeals. General Rule rule. The Contractor must establish and maintain an expedited review process for appeals, when the Contractor determines (for a request from the member) or the provider indicates (in making the request on the member's behalf or supporting the member's request) that taking the time for a standard resolution could seriously jeopardize the member's life or health or ability to attain, maintain, or regain maximum function.
Appears in 1 contract
Samples: msp.scdhhs.gov