Notice of Adverse Action. The CONTRACTOR must notify the requesting provider, and give the member written notice of any decision by the CONTRACTOR to deny a service authorization request, or to authorize a service in an amount, duration, or scope that is less than requested. The notice must meet the requirement of 42 CFR Section 438.404, except that the notice to the provider need not be in writing.
Appears in 2 contracts
Samples: Medicaid Managed Care Services Agreement (Molina Healthcare Inc), Agreement No. PSC 02 05 (BHC Physician Services of Kentucky LLC)
Notice of Adverse Action. The CONTRACTOR must notify the requesting provider, and give the member written notice notice, of any decision by the CONTRACTOR to deny a service authorization request, request or to authorize a service in an amount, duration, or scope that is less than requested. The notice must meet the requirement requirements of 42 CFR Section 438.404, except that the notice to the provider need not be in writing.
Appears in 1 contract
Samples: Medicaid Managed Care Services Agreement (Molina Healthcare Inc)
