Common Contracts
2 similar Member Agreement contracts
ENROLLEE / MEMBER AGREEMENT FOR ADDITIONAL INFORMATION REQUESTMember Agreement • August 12th, 2020
We received the request for an appeal on <insert date> from your provider. However, in order to make a fair and informed determination, we requested the following information be sent within five (5) calendar days for a standard appeal request and immediately for an expedited appeal request from you provider:
ENROLLEE / MEMBER AGREEMENT FOR ADDITIONAL INFORMATION REQUESTMember Agreement • October 11th, 2019
We received the request for an appeal on <insert date> from your provider. However, in order to make a fair and informed determination, we requested the following information be sent within five (5) calendar days for a standard appeal request and immediately for an expedited appeal request from you provider:
