Common use of Time Frames for Appeal Resolution and Notification Clause in Contracts

Time Frames for Appeal Resolution and Notification. (A) The Contractor shall resolve each Appeal and provide notice of resolution to affected parties as expeditiously as the Enrollee’s health condition requires but no later than 30 calendar days from the day the Contractor receives the written, signed Appeal. (B) The Contractor may extend the time frame for resolving the Appeal and providing notice by up to 14 calendar days if: (1) the Aggrieved Party requests the extension; or (2) the Contractor shows that (to the satisfaction of the Department, upon its request) there is a need for additional information and how the delay is in the Aggrieved Party’s interest. (C) If the Contractor extends the time frame, and the extension was not requested by the Aggrieved Party, the Contractor shall give the Aggrieved Party written notice of the reason for the delay.