Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.
Appears in 44 contracts
Samples: Preferred Provider Organization Contract, Participating Provider Organization Insurance Policy, Insurance Policy
Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary, Necessary You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.
Appears in 13 contracts
Samples: Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract
Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary,, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.
Appears in 2 contracts
Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically NecessaryNecessary , You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.
Appears in 1 contract
Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.
Appears in 1 contract
Samples: Student Vision Insurance Policy
Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is does not Medically Necessarymeet Our requirements for Medical Necessity, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.
Appears in 1 contract
