Standard Resolution. The Contractor shall respond in writing to standard appeals as expeditiously as the enrollee’s health condition requires and shall not exceed the required calendar days from the initial date of receipt of the appeal. The Contractor may extend this timeframe by up to an additional fourteen (14) calendar days if the enrollee requests the extension or if the Contractor provides evidence satisfactory to the Division that a delay in rendering the decision is in the enrollee’s interest. For any appeals decisions not rendered within the required calendar days where the enrollee has not requested an extension, the Contractor shall provide written notice to the enrollee of the reason for the delay. For any appeal decision that is pending the receipt of additional information, the Contractor shall issue a decision within no more than forty-five (45) calendar days from the initial date of receipt of the appeal.
Appears in 4 contracts
Samples: medicaid.ms.gov, medicaid.ms.gov, www.medicaid.ms.gov
