Response to Formal Grievances. Company’s Grievance Panel shall meet once a month to review written grievances submitted. If the Grievance Panel requires further information from the Member, then the Member may be asked to appear before the Grievance Panel. The Grievance Panel shall render a decision and communicate such decision, in writing, to the grievant within ten (10) days after the Grievance Panel’s meeting. If the grievance involves a dentally- related matter or claim, Company’s Dental Director shall be involved in resolving said grievance. If the grievance involves denial of benefits or services, the written decision shall reference the specific provisions of this Certificate upon which the denial is based. All grievances shall be processed within sixty (60) days by Company. However, if the grievance involves collection of information from outside Company’s service area, an additional thirty (30) days will be allowed for processing.
Appears in 5 contracts
Samples: Dental Plan Agreement, Dental Plan Agreement, Dental Plan Agreement
Response to Formal Grievances. Company’s 's Grievance Panel shall meet once a month to review written grievances submitted. If the Grievance Panel requires further information from the Member, then the Member may be asked to appear before the Grievance Panel. The Grievance Panel shall render a decision and communicate such decision, in writing, to the grievant within ten (10) days after the Grievance Panel’s 's meeting. If the grievance involves a dentally- related matter or claim, Company’s 's Dental Director shall be involved in resolving said grievance. If the grievance involves denial of benefits or services, the written decision shall reference the specific provisions of this Certificate upon which the denial is based. All grievances shall be processed within sixty (60) days by Company. However, if the grievance involves collection of information from outside Company’s 's service area, an additional thirty (30) days will be allowed for processing.
Appears in 2 contracts
Samples: Agreement and Certificate of Benefits, Agreement and Certificate of Benefits
Response to Formal Grievances. Company’s 's Grievance Panel shall meet once a month to review written grievances submitted. If the Grievance Panel requires further information from the Member, then the Member may be asked to appear before the Grievance Panel. The Grievance Panel shall render a decision and communicate such decision, in writing, to the grievant within ten (10) days after the Grievance Panel’s 's meeting. If the grievance involves a dentally- dental-related matter or claim, Company’s 's Dental Director shall be involved in resolving said grievance. If the grievance involves denial of benefits or services, the written decision shall reference the specific provisions of this Certificate upon which the denial is based. All grievances shall be processed within sixty (60) days by Company. However, if the grievance involves collection of information from outside Company’s 's service area, an additional thirty (30) days will be allowed for processing.
Appears in 1 contract
Samples: Insurance Agreement
Response to Formal Grievances. Company’s Grievance Panel shall meet once a month to review written grievances submitted. If the Grievance Panel requires further information from the Member, then the Member may be asked to appear before the Grievance Panel. The Grievance Panel shall render a decision and communicate such decision, in writing, to the grievant within ten (10) days after the Grievance Panel’s meeting. If the grievance involves a dentally- dental-related matter or claim, Company’s Dental Director shall be involved in resolving said grievance. If the grievance involves denial of benefits or services, the OHGNCERT04 11 written decision shall reference the specific provisions of this Certificate upon which the denial is based. All grievances shall be processed within sixty (60) days by Company. However, if the grievance involves collection of information from outside Company’s service area, an additional thirty (30) days will be allowed for processing.
Appears in 1 contract
Samples: Dental Plan Agreement