Common Contracts
1 similar General Consent and Agreements for Hospital Ambulatory Services contracts
A Location of Stony Brook University HospitalGeneral Consent and Agreements for Hospital Ambulatory Services • August 30th, 2017
The patient, the patient’s designee and the patient’s provider have a right to an external appeal of certain adverse determination made by health plans. In the event an external appeal is filed, consent to the release of medical records signed and dated by the patient is necessary. An external appeal agent, assigned by the New York State Department of Financial Services, will use this consent to obtain medical information from the patient’s health plan and health care providers. The name and address of the external appeal agent will be provided with the request for medical information.
