Scope of Review. The person who reviews and decides the Member’s appeal will be a different individual than the person who decided the initial adverse benefit determination. The review on appeal will not give deference to the initial adverse benefit determination and will be made anew. The Plan will not make any decision regarding hiring, compensation, termination, promotion or other similar matters with respect to the individual selected to conduct the review on appeal based upon how the individual will decide the appeal.
Appears in 6 contracts
Samples: Health Insurance Contract, Health Insurance Contract, Health Insurance Plan
