Notification of Non Covered Benefit. In accordance with Article XI, Section D.1, the PO shall provide a Notification of Non Covered Benefit (xxxxx://xxx.xxx.xxxxxxxxx.xxx/forms/f00950a.docx)to the member when a decision is made to: Deny a member’s request for an excluded service; or Deny a member's request for payment of an excluded service.
Appears in 2 contracts
Samples: Pace Contract, Pace Contract
Notification of Non Covered Benefit. In accordance with Article XI, Section D.1, the PO shall provide a Notification of Non Covered Benefit (xxxxx://xxx.xxx.xxxxxxxxx.xxx/forms/f00950a.docx)to xxxxx://xxx.xxx.xxxxxxxxx.xxx/library/f-01283.htm)to the member when a decision is made to: Deny a member’s request for an excluded service; or Deny a member's request for payment of an excluded service.
Appears in 1 contract
Samples: Pace Contract
Notification of Non Covered Benefit. In accordance with Article XI, Section D.1, the PO shall provide a Notification of Non Covered Benefit (xxxxx://xxx.xxx.xxxxxxxxx.xxx/forms/f00950a.docx)to the member when a decision is made to: :
a. Deny a member’s request for an excluded service; or or
b. Deny a member's request for payment of an excluded service.
Appears in 1 contract
Samples: Pace Contract
Notification of Non Covered Benefit. In accordance with Article XI, Section D.1XI.D.1, the PO shall provide a Notification of Non Covered Benefit (xxxxx://xxx.xxx.xxxxxxxxx.xxx/forms/f00950a.docx)to xxxxx://xxx.xxx.xxxxxxxxx.xxx/library/f-01283.htm)to the member when a decision is made to: :
a. Deny a member’s request for an excluded service; or or
b. Deny a member's request for payment of an excluded service.
Appears in 1 contract
Samples: Pace Contract