Level Concurrent Review Grievance - Timeframe for Completion and Notification Sample Clauses

Level Concurrent Review Grievance - Timeframe for Completion and Notification. A. A grievance related to a request to continue or extend a course of treatment shall be decided as soon as possible consistent with the medical exigencies of the case. MVP shall notify you and your treating provider of our determination (whether adverse or not) as soon as possible consistent with the medical exigencies of the case, but not later than twenty-four (24) hours after receipt of the grievance. B. In the case of a grievance related to an adverse concurrent review determination, neither you nor the provider shall be liable for any services provided before notification to you of the adverse benefit determination and the final outcome of any grievance or independent external review, unless the treating provider or designee has refused or repeatedly failed to engage in communication with MVP when it has been offered at a time in a manner reasonably convenient for the provider, in which case the provider, not you, shall be liable for any services provided. C. We shall notify the treating provider and you of the determination orally as soon as the determination has been made. Written (either hard copy or, if elected by your or your treating provider, appropriately secure electronic) confirmation of the determination shall be sent to the treating provider and you within twenty-four
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