Payment for Covered Services. The final decision as to whether any care should be received is between the Insured and the Provider. If SHL denies a request by an Insured and/or Provider for Prior Authorization of a service, the Insured or his Authorized Representative may appeal the denial to the Grievance Review Committee (see the Appeals Procedures Section).
Appears in 4 contracts
Samples: Agreement of Coverage, Epo Agreement of Coverage, Epo Agreement of Coverage
