Urgent Care Claims. In the case of a Claim Involving Urgent Care, the Member, the Member’s Representative or Health Care Provider acting on behalf of the Member shall be notified, in accordance with paragraph X. xxxxxx, of the Grievance Decision as soon as possible, taking into account the medical exigencies, but not later than 24 hours after receipt of the Member's request for review of an Adverse Decision. A written Notification must be provided to the Member, the Member’s Representative or Health Care Provider acting on behalf of the Member within 24 hours of the orally communicated Grievance Decision.
Appears in 4 contracts
Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement
Urgent Care Claims. In the case of a Claim Involving Urgent Care, the Member, the Member’s Member‟s Representative or Health Care Provider acting on behalf of the Member shall be notified, in accordance with paragraph X. xxxxxxJ. herein, of the Grievance Decision as soon as possible, taking into account the medical exigencies, but not later than 24 hours after receipt of the Member's request for review of an Adverse Decision. A written Notification must be provided to the Member, the Member’s Member‟s Representative or Health Care Provider acting on behalf of the Member within 24 hours of the orally communicated Grievance Decision.
Appears in 3 contracts
Samples: In Network Group Contract, In Network Group Contract, In Network Group Contract
Urgent Care Claims. In the case of a Claim Involving Urgent Care, the Member, the Member’s Representative or Health Care Provider acting on behalf of the Member shall be notified, in accordance with paragraph X. xxxxxxJ. herein, of the Grievance Decision as soon as possible, taking into account the medical exigencies, but not later than 24 hours after receipt of the Member's request for review of an Adverse Decision. A written Notification must be provided to the Member, the Member’s Representative or Health Care Provider acting on behalf of the Member within 24 hours of the orally communicated Grievance Decision.
Appears in 3 contracts
Samples: In Network Individual Enrollment Agreement, Individual Plan Agreement, Individual Enrollment Agreement for a Qualified Health Plan
Urgent Care Claims. In the case of a Claim Involving Urgent Care, the Member, the Member’s 's Representative or Health Care Provider acting on behalf of the Member shall be notified, in accordance with paragraph X. xxxxxxJ. herein, of the Grievance Decision as soon as possible, taking into account the medical exigencies, but not later than 24 hours after receipt of the Member's request for review of an Adverse Decision. A written Notification must be provided to the Member, the Member’s 's Representative or Health Care Provider acting on behalf of the Member within 24 hours of the orally communicated Grievance Decision.
Appears in 2 contracts
Samples: Student Health Plan Individual Enrollment Agreement, Student Health Plan Individual Enrollment Agreement
Urgent Care Claims. In the case of a Claim Involving Urgent Care, the Member, the Member’s 's Representative or Health Care Provider acting on behalf of the Member shall be notified, in accordance with paragraph X. xxxxxx, of the Grievance Decision as soon as possible, taking into account the medical exigencies, but not later than 24 hours after receipt of the Member's request for review of an Adverse Decision. A written Notification must be provided to the Member, the Member’s 's Representative or Health Care Provider acting on behalf of the Member within 24 hours of the orally communicated Grievance Decision.
Appears in 1 contract
Samples: Member Contract
