Common use of What Should You Do When You Want to Appeal a Decision Clause in Contracts

What Should You Do When You Want to Appeal a Decision. If You want to ask Us to change a decision that We made, You may file an Appeal. For example, You may Appeal Our decision if We denied a Claim based on Plan limitations or exclusions. When You file an Appeal, send Us all of the information You have so that We can completely evaluate Your situation. We try to respond quickly, review any documentation in a timely manner, and resolve disputes effectively. The Appeals process has two levels, including a committee review at the second level. Send Us only one request for an issue. We will not consider multiple requests to Appeal the same Claim, service, issue, or date of service at any level of review.‌‌ If You prefer, You can have someone else act for You. We call that person an authorized representative. If You want to name Your doctor or someone else as an authorized representative, You must write to Us that You want someone to work with Us for an Appeal of denied Benefits. 1. We will notify Your providers of the Appeal results only if they filed the Appeal for You.

What Should You Do When You Want to Appeal a Decision. If You want to ask Us to change a decision that We made, You may file an Appeal. For example, You may Appeal Our decision if We denied a Claim based on Plan limitations or exclusions. When You file an Appeal, send Us all of the information You have so that We can completely evaluate Your situation. We try to respond quickly, review any documentation in a timely manner, and resolve disputes effectively. The Appeals process has two levels, including a committee review at the second level. Send Us only one request for an issue. We will not consider multiple requests to Appeal the same Claim, service, issue, or date of service at any level of review.‌‌ review.‌ If You prefer, You can have someone else act for You. We call that person an authorized representative. If You want to name Your doctor or someone else as an authorized representative, You must write to Us that You want someone to work with Us for an Appeal of denied Benefits. 1. We will notify Your providers of the Appeal results only if they filed the Appeal for You.