Common use of External Review of Grievances Clause in Contracts

External Review of Grievances. You may pursue an External Appeal if You are not satisfied with Our Appeal decision. An Independent Review Organization ("IRO") is available for Appeals that involve an Adverse Determination of any of the following. (A) a Medically Necessary Service. (B) a Utilization Review Determination. (C) the experimental or investigational nature of a proposed Health Service.

External Review of Grievances. You may pursue an External Appeal if You are not satisfied with Our Appeal decision. An Independent Review Organization ("IRO") is available for Appeals that involve an Adverse Determination of any of the following.: (A) a Medically Necessary Service. (B) a Utilization Review Determination. (C) the experimental or investigational nature of a proposed Health Service.

External Review of Grievances. You may pursue an External Appeal if You are not satisfied with Our Appeal decision. An Independent Review Organization ("IRO") is available for Appeals that involve an Adverse Determination of any of the following.: (A) a Medically Necessary Service., (B) a Utilization Review Determination., or (C) the experimental or investigational nature of a proposed Health Service., or

External Review of Grievances. You may pursue an External Appeal if You are not satisfied with Our Appeal decision. An Independent Review Organization ("IRO") is available for Appeals that involve an Adverse Determination of any of the following. (A) a Medically Necessary Service. (B) a Utilization Review Determination. (C) the experimental or investigational nature of a proposed Health Service.: