Common use of Standard Appeal Procedures Clause in Contracts

Standard Appeal Procedures. Multiple requests to Appeal the same Claim, service, issue, or date of service will not be considered, at any level of review. UCD offers two (2) levels of Appeal for both administrative Appeals and Dental Necessity Appeals. If a Member is an ERISA Member, the Member is required to complete the first level of Appeal prior to instituting any civil action under ERISA section 502(a). The second level of Appeal is voluntary. Any statute of limitations or other defense based on timeliness is tolled during the time any voluntary Appeal is pending. The Member’s decision whether or not to submit to this voluntary level of review will have no effect on the Member’s rights to any other Benefits under the plan. No fees or costs will be imposed on the Member. The Member should contact his employer, Plan Administrator, Plan Sponsor, or UCD at 0-000-000-0000 if the Member is unsure whether ERISA is applicable.‌‌‌ The Member may also call UCD if they have questions or need assistance putting their Appeal in writing.

Standard Appeal Procedures. Multiple requests to Appeal the same Claim, service, issue, or date of service will not be considered, at any level of review. UCD offers two (2) levels of Appeal for both administrative Appeals and Dental Necessity Appeals. If a Member is an ERISA Member, the Member is required to complete the first level of Appeal prior to instituting any civil action under ERISA section 502(a). The second level of Appeal is voluntary. Any statute of limitations or other defense based on timeliness is tolled during the time any voluntary Appeal is pending. The Member’s decision whether or not to submit to this voluntary level of review will have no effect on the Member’s rights to any other Benefits under the plan. No fees or costs will be imposed on the Member. The Member should contact his employer, Plan Administrator, Plan Sponsor, or UCD at 0-000-000-0000 if the Member is unsure whether ERISA is applicable.‌‌‌ applicable. The Member may also call UCD if they have questions or need assistance putting their Appeal in writing.

Standard Appeal Procedures. Multiple requests to Appeal the same Claim, service, issue, or date of service will not be considered, at any level of review. UCD offers two (2) levels of Appeal for both administrative Administrative Appeals and Dental Necessity Appeals. If a Member is an ERISA Member, the Member is required to complete the first level of Appeal prior to instituting any civil action under ERISA section 502(a). The second level of Appeal is voluntary. Any statute of limitations or other defense based on timeliness is tolled during the time any voluntary Appeal is pending. The Member’s decision whether or not to submit to this voluntary level of review will have no effect on the Member’s rights to any other Benefits under the plan. No fees or costs will be imposed on the Member. The Member should contact his employer, Plan Administrator, Plan Sponsor, or UCD at 0-000-000-0000 if the Member is unsure whether ERISA is applicable.‌‌‌ which process applies to him. The Member may also call UCD if they have questions or need needs assistance putting their the Appeal in writing. Providers will be notified of Appeals results only if the Provider filed the Appeal.