Common use of Expedited Review Timing and Notification Clause in Contracts

Expedited Review Timing and Notification. For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving