Appeal decision means a final determination made by us that arises from an appeal filed with us under our appeal process regarding a coverage decision concerning a Covered person.
Appeal decision means a final determination made by us that arises from an appeal filed with us under our appeal process regarding a coverage decision concerning a Covered Person.
Examples of Appeal decision in a sentence
The Plan or the Plan‟s Designee shall provide a Member, the Member‟s Representative or Health Care Provider acting on behalf of the Member with written or electronic Notification after it has provided oral communication of the Grievance Decision or Appeal Decision.
Student remains responsible for all occupancy and other applicable charges (as determined by the University) per this agreement until Housing and Residence Life provides a written Appeal Decision.
Within 4 months after the date of receipt of an Appeal Decision or a Grievance Decision, a Member, the Member‟s Representative or Health Care Provider acting on behalf of the Member may file a Complaint with the Commissioner for review of the Grievance Decision or Appeal Decision.
More Definitions of Appeal decision
Appeal decision means a written or electronic notice in response to an appeal under this chapter provided to a contracted pharmacy that includes a reason for the appeal denial.
Appeal decision means a final determination by Delta Dental that arises from an Appeal filed with Delta Dental under our appeal process regarding a Coverage Decision concerning an Enrollee.
Appeal decision means a final determination by us after a review of an appeal regarding a coverage decision. “Compelling Reason” means a showing that the potential delay in receipt of a health care service until after
Appeal decision means a written or electronic notice issued by a PBM in response to an appeal filed by a contracted pharmacy of the maximum allowable cost used to adjudicate a claim.
Appeal decision. A final determination by the Health Plan that arises from an Appeal filed with the Health Plan under its internal Appeal process regarding a Coverage Decision concerning a Member.
Appeal decision means Aetna’s final determination on a appeal filed by you through Aetna's internal appeal process for adverse decisions.
Appeal decision means Aetna’s final determination on a claim filed by you through Aetna's internal claims and appeal process, at the final internal appeal level, for adverse decisions.