Common use of Notice of Adverse Benefit Determination Clause in Contracts

Notice of Adverse Benefit Determination. If Contractor determines that the medical necessity criteria has not been met, then a written Notice of Adverse Benefit Determination (NOABD) shall be issued in accordance with 42 C.F.R. Section 438.404 in compliance with Department Policy #4.010 Notice of Adverse Benefit Determination.

Notice of Adverse Benefit Determination. If Contractor determines that the medical necessity criteria has not been met, then a written Notice of Adverse Benefit Determination (NOABD) shall be issued in accordance with 42 C.F.R. Section CFR 438.404 in compliance with Department Policy #4.010 Notice of Adverse Benefit Determination.

Notice of Adverse Benefit Determination. If Contractor determines that the medical necessity criteria has not been met, then a written Notice of Adverse Benefit Determination (NOABD) shall be issued in accordance with 42 C.F.R. Section CFR 438.404 in compliance with Department Policy #4.010 Notice of Adverse Benefit Determinationand 42 CFR 438.10.

Notice of Adverse Benefit Determination. If Contractor determines that the medical necessity criteria has not been met, then a written Notice of Adverse Benefit Determination (NOABD) shall be issued in accordance with 42 C.F.R. Section 438.404 in compliance with 438.404, 42 C.F.R. Section 438.10, and Department Policy #4.010 Notice of Adverse Benefit Determination.