Second Level Appeal Sample Clauses

Second Level Appeal. If you file a first level appeal and it is denied, wholly or in part, you have the right to request external review of our decision without filing a second level appeal. See below for a description of this process. If your appeal does not involve a determination of medical necessity, at your option, you or your authorized representative may, within 180 days of denial submit a written request for a second level appeal, including any relevant documents, and submit issues, comments and additional information as appropriate to: GHI Member Services Department 0000 00xx Xxxxxx Xxxxx P.O. Box 9463 Minneapolis, MN 00000-0000 Telephone: (000) 000-0000 Outside the metro area: 0-000-000-0000 The Member Services Department will provide the complainant with the option of either a written reconsideration, or a hearing before the Member Appeals Committee either in person or over the telephone. Hearings and written reconsiderations shall include the receipt of testimony, correspondence, explanations, or other information from the complainant, staff persons, administrators, providers, or other persons, as is deemed necessary for a fair appraisal and resolution of the appeal. During your appeal, upon your request we will provide you, free of charge, reasonable access to all documents, records and other information relevant to your appeal. We will review your appeal and written notice of the decision and all key findings will be given to the complainant within 30 calendar days of the Member Services Department’s receipt of the complainant’s written notice of appeal and request for written reconsideration. These time periods may be extended if you agree.
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Second Level Appeal. If you file a first level appeal (including pre-certification under CareCheck®) and it is denied, wholly or in part, you have the right to request external review of our decision without filing a second level appeal. See below for a description of this process. If your appeal does not involve a determination of medical necessity of Precertification, at your option, you or your authorized representative may, within 180 days of denial submit a written request for a second level appeal, including any relevant documents, and submit issues, comments and additional information as appropriate to: GHI Member Services Department 0000 00xx Xxxxxx Xxxxx P.O. Box 9463 Minneapolis, MN 00000-0000 Telephone: (000) 000-0000 Outside the metro area: 0-000-000-0000 The Member Services Department will provide the complainant with the option of either a written reconsideration, or a hearing before the Member Appeals Committee either in person or over the telephone. Hearings and written reconsiderations shall include the receipt of testimony, correspondence, explanations, or other information from the complainant, staff persons, administrators, providers, or other persons, as is deemed necessary for a fair appraisal and resolution of the appeal. During your appeal, upon your request we will provide you, free of charge, reasonable access to all documents, records and other information relevant to your appeal. We will review your appeal and written notice of the decision and all key findings will be given to the complainant within 30 calendar days of the Member Services Department’s receipt of the complainant’s written notice of appeal and request for written reconsideration. These time periods may be extended if you agree.
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Second Level Appeal. An employee who disagrees with the decision of the Principal may file a written appeal to the Labor/Management Panel. Appeals must be filed in writing with the Chief Human Resources Officer or designee within ten (10) working days of the receipt of the finding at the First Level Appeal. The Second Level Appeal is conducted by the Labor/Management Panel, which is composed of three Local 1 representatives appointed by Local 1, a College Business Manager appointed by the District, the Chief Human Resources Officer, and a mutually selected HR professional from another public agency. The Principal Human Resources Representative may attend and serve as a resource to the Panel. 17.5.6.2.1 On a date mutually agreed upon between the employee and the Labor/Management Panel, the Second Level Appeal meeting will convene. The Labor/Management Panel will meet with the employee and the Principal to review the findings of the First Level Appeal. The supervisor may be asked to attend and address the panel. The employee may ask that a union representative be present. 17.5.6.2.2 The Labor/Management Panel will render a decision and communicate that decision in writing to District Human Resources. The Panel’s decision must be unanimous. Human Resources will notify the employee and Local 1. Those appeals rejected due to a lack of a unanimous decision may be appealed to the Chief Human Resources Officer.
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Second Level Appeal. A second level appeal will be reviewed by the Executive Director with additional input as necessary. A second level appeal will be responded to within 60 days via a letter to Provider.
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Second Level Appeal. Administrative Resolution
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Second Level Appeal. If Provider disagrees with the decision made during the first level appeal, Provider will be permitted to appeal to an appeals committee consisting of one person selected by each party to the appeal and one person mutually agreeable to both parties. The parties to the appeal will pay to the appeal committee any costs associated with the person they select and shall share the costs of the person mutually agreeable to both parties, which costs shall not be recoverable by the other party.
Sample 1
Second Level Appeal. If the dispute or claim is still not resolved to Contractor’s satisfaction at the First Level Appeal level, Contractor may file a written Second Level Appeal, within thirty (30) calendar days following the determination from the First Level Appeal, with the HIS SSM II at the following address: California Correctional Health Care Services Healthcare Invoicing Section Attn: Appeals SSM II PO Box 588500, Building D Elk Grove, CA 95758 The Second Level Appeal shall be sent with additional supporting justification to the detailed reason(s) of dispute in regards to the First Level Appeal, along with the denial letter and all original supporting documentation provided for the First Level Appeal. The HIS SSM II or designee shall issue a written decision in response to Contractor’s Second Level Appeal within fifteen (15) calendar days of receipt of the Second Level Appeal. The written decision shall either: (a) Document the dispute settlement and what, if any, conditions were reached; or (b) Document the reason(s) the dispute could not be resolved and provide notification to Contractor of its option to file an Administrative Resolution within thirty (30) calendar days of the date of the written decision.
Sample 1
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Related to Second Level Appeal

  • Level I If the grievance is not resolved through informal discussions, the School District designee shall give a written decision on the grievance to the parties involved within ten (10) days after receipt of the written grievance.

  • Level 1 If an Employee wishes to submit a grievance, he/she shall first discuss the complaint with his/her immediate supervisor. The Grievance Committee representative and one administrator may also be present. This discussion must occur within ten (10) days of the event causing the complaint.

  • Level Four A. If within ten (10) school days following the formal third step the Association submits a request to the Superintendent to enter into arbitration, the Superintendent and the Association shall attempt to agree upon a mutually acceptable arbitrator and shall obtain a commitment from said arbitrator to serve. If the parties are unable to agree upon an arbitrator or to obtain such a commitment within ten (10) school days, a written request for a list of arbitrators shall be made to the Public Employment Relations Board (PERB) by either party. The list shall consist of seven (7) potential arbitrators and the parties shall determine by lot which party shall have the right to remove the first name from the list. The party having the right to remove the first name shall do so within two (2) school days. Then the parties shall have one (1) school day alternately to remove until one (1) name remains. The person whose name remains shall be the arbitrator. B. The arbitrator so selected shall confer with the Superintendent and the Association and hold hearings promptly and shall issue his/her decision not later than fifteen (15) school days from the date of the close of the hearings, or, if oral hearings have been waived, then from the date the final statements and proofs on the issues are submitted to him/her. The arbitrator's decision shall be in writing and shall set forth his/her findings of fact, reasoning, and conclusions of the issues submitted. The arbitrator's decision shall have no power to alter, add to, or detract from the specific provisions of the Agreement. No decision of the arbitrator shall in any way be derogation of the powers, duties, and rights established in the Board by constitutional provisions, statue, ordinance, or special legislative acts. The decision of the arbitrator shall be submitted to the Superintendent and the Association and shall be final and binding on the parties. C. The costs of the services of the arbitrator will be borne equally by the Board and the Association. D. If the grievant files any claim or complaint in any forum other than under the grievance procedure of this Master Contract Agreement, then the school district shall not be required to process the same claim or set of facts through this grievance procedure.

  • Level IV a. If the grievant is not satisfied with the disposition of his/her grievance at Level III, he/she may file the grievance within five (5) days of the Level III response for transmittal to the Board. b. The Board will hear the grievance at its next regularly scheduled meeting or a special meeting which has been called for that purpose. The Board shall transmit its written decision to the grievant within five (5) days of the meeting. The decision of the Board shall be final. Nothing in this section shall be construed so as to deny a grievant any appeal rights available under the law.

  • Level 2 If the grievant is not satisfied with the written answer from his/her manager the grievant may, within ten (10) days from the receipt of such answer, file a written appeal to the appointing authority. Within ten (10) days of the receipt of the written appeal the appointing authority shall investigate the grievance, which shall include a meeting with the concerned parties, and thereafter shall give a written answer to the grievant within ten (10) days.

  • Level II In the event the grievance is not resolved in Level I, the decision rendered may be appealed to the Superintendent of Schools, provided such an appeal is made in writing within ten (10) days after receipt of the decision in Level I. If a grievance is properly appealed to the Superintendent, the Superintendent or his/her designee shall meet regarding the grievance within fifteen (15) days after receipt of the appeal. Within ten (10) days after the meeting, the Superintendent or his/her designee shall issue a decision, in writing, to the parties involved.

  • ALTERNATE SCHOOL CALENDAR 1. In this article, an alternative school calendar is a school calendar that differs from the standard school calendar as specified in Schedule 1 (Supplement) of the School Calendar Regulation 114/02. 2. When a school district intends to implement an alternate school calendar, written notification shall be provided to the local no later than forty (40) working days prior to its implementation. The employer and the local shall meet within five (5) working days following receipt of such notice to negotiate modifications to the provisions of the agreement that are directly or indirectly affected by the proposed change(s). The aforesaid modifications shall preserve, to the full legal extent possible, the original intent of the agreement. 3. The process outlined below in Article D.6.4 through Article D.

  • Level 4 If the Employee is not satisfied with the response of the Assistant Superintendent for Administrative Services, the Employee may submit the grievance to the Superintendent within ten (10) days of the receipt of the response to Level 3. The Superintendent shall sign and date all copies when he/she receives them. The Superintendent shall respond in writing within ten (10) days of the above date. Either party may be accompanied by one other Employee or administrator.

  • Long Term Cost Evaluation Criterion # 4 READ CAREFULLY and see in the RFP document under "Proposal Scoring and Evaluation". Points will be assigned to this criterion based on your answer to this Attribute. Points are awarded if you agree not i ncrease your catalog prices (as defined herein) more than X% annually over the previous year for years two and thr ee and potentially year four, unless an exigent circumstance exists in the marketplace and the excess price increase which exceeds X% annually is supported by documentation provided by you and your suppliers and shared with TIP S, if requested. If you agree NOT to increase prices more than 5%, except when justified by supporting documentati on, you are awarded 10 points; if 6% to 14%, except when justified by supporting documentation, you receive 1 to 9 points incrementally. Price increases 14% or greater, except when justified by supporting documentation, receive 0 points. increases will be 5% or less annually per question Required Confidentiality Claim Form This completed form is required by TIPS. By submitting a response to this solicitation you agree to download from th e “Attachments” section, complete according to the instructions on the form, then uploading the completed form, wit h any confidential attachments, if applicable, to the “Response Attachments” section titled “Confidentiality Form” in order to provide to TIPS the completed form titled, “CONFIDENTIALITY CLAIM FORM”. By completing this process, you provide us with the information we require to comply with the open record laws of the State of Texas as they ma y apply to your proposal submission. If you do not provide the form with your proposal, an award will not be made if your proposal is qualified for an award, until TIPS has an accurate, completed form from you. Read the form carefully before completing and if you have any questions, email Xxxx Xxxxxx at TIPS at xxxx.xxxxxx@t xxx-xxx.xxx

  • SERVICE LEVEL DESCRIPTION The Fund Accounting Agreement is hereby amended by deleting the Service Level Description attached thereto and replacing it in its entirety with the Service Level Description attached hereto.

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