Common use of Standard Internal Appeal Process Clause in Contracts

Standard Internal Appeal Process. The Contractor must notify the Enrollee of the internal Appeal decision as expeditiously as the Enrollee’s health requires, but no later than 30 calendar days after the Contractor’s receipt of the Appeal. The Contractor may extend this time frame up to 14 calendar days if the Enrollee requests the extension or if the Contractor justifies the need for additional information and how the extension of time benefits the Enrollee. When the Contractor takes an extension, the Enrollee must be notified in writing.

Standard Internal Appeal Process. 1) The Contractor must notify the Enrollee of the internal Appeal decision as expeditiously as the Enrollee’s health requires, but no later than 30 calendar days after the Contractor’s receipt of the Appeal. The Contractor may extend this time frame up to 14 calendar days if the Enrollee requests the extension or if the Contractor justifies the need for additional information and how the extension of time benefits the Enrollee. When the Contractor takes an extension, the Enrollee must be notified in writing.