Common use of Your Right to Appeal A Determination that A Service Is Not Medically Necessary Clause in 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 Necessary, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 43 contracts

Samples: assets.ctfassets.net, assets.ctfassets.net, mydental.guardianlife.com

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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: www.bcbswny.com, 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

Samples: healthplex.com, healthplex.com

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

Samples: www1.deltadentalins.com

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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: www.aetnastudenthealth.com

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

Samples: www.cdphp.com

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