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 Enrollee requests the extension; or (2) the Contractor shows that (to the satisfaction of the Department, upon its request) there is no need for additional information and how the delay is in the Enrollee’s interest. (C) If the Contractor extends the time frame, and the extension was not requested by the Enrollee, the Contractor shall give the Enrollee written notice of the reason for the delay.
Appears in 6 contracts
Samples: Chip Dentaquest Amendment 2, Chip Select Health Amendment 1, Chip Premier Access Dental Contract Amendment 2
