First Level Formal Appeal Sample Clauses

First Level Formal Appeal. If Contractor disagrees with the UM Physician/Advisor’s decision after an informal appeal, a first level formal appeal shall be submitted to the UM Deputy Medical Executive (DME). Contractor must appeal in writing to the address below, within sixty (60) calendar days of receipt of the UM Physician/Advisor’s notice to uphold the denial or deferral of service: Attention: Utilization Management Deputy Medical Executive Utilization Management California Correctional Health Care Services P.O. Box 588500 Elk Grove, CA 95758 The UM DME will evaluate the appeal and respond within sixty (60) calendar days.
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Related to First Level Formal Appeal

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  • Level Two – Formal If the Grievant is dissatisfied with the disposition of the grievance at Level One – Formal, the Grievant may complete Level Two Grievance Form and submit to the Superintendent within ten (10) days of written disposition of Level One – Formal. Within ten (10) days of receipt of the Level Two Grievance Form, the Superintendent shall meet with the Grievant. The Superintendent shall execute written disposition of the grievance within ten (10) days of such meeting.

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  • Formal Grievance - Step 3 A. If the grievant is not satisfied with the decision rendered pursuant to Step 2, the grievant may appeal the decision within twenty-one (21) calendar days after receipt to a designated supervisor or manager identified by each department head as the third level of appeal. If the department head or designee is the second level of appeal, the grievant may bypass Step 3.

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