Common use of Time Periods for Decisions on Appeal Clause in Contracts

Time Periods for Decisions on Appeal. Appeals of claims denials will be decided and notice of the decision provided as follows: Urgent-care Claims As soon as possible but no later than 72 hours after Humana receives the appeal request. Pre-service Claims Within a reasonable period but no later than 30 days after Humana receives the appeal request. Post-service Claims Within a reasonable period but no later than 60 days after Humana receives the appeal request Concurrent-care Decisions Within the time periods specified above depending on the type of claim involved.