Examples of Expedited external review in a sentence
Expedited external review will not be provided for retrospective adverse or final adverse determinations.
Expedited external review decisions will be issued within 24 hours of the IRE’s receipt of all information required from us.
Expedited external review is available only if the patient’s treating health care provider certifies that adherence to the time frame for the standard external review would seriously jeopardize the life or health of the covered person or would jeopardize the covered person’s ability to regain maximum function.
Upon receipt of a notice of a final external review decision reversing the adverse benefit determination or final adverse benefit determination, the plan or issuer immediately must provide coverage or payment (including immediately authorizing care or immediately paying benefits) for the claim.(3) Expedited external review.
Expedited external review (1) Request for expedited external review.
F, G, H, and I.By September, DOE still had not paid all the tuition ordered pursuant to Tuition Orders since March 2020.
Expedited external review: You may seek expedited external review in certain circumstances where any delay in issuing a benefit determination would seriously jeopardize your life, health or your ability to regain maximum function or your claim involves emergency treatment and you have not been released from the treating facility.
Expedited external review The process for an Expedited External Review is as follows: 1.
Expedited external review Urgent or Emergency CareThis Plan does not require a Participant to obtain prior approval for pre-service urgent care Claims or emergency care services before getting treatment; therefore, neither the internal appeals nor the external review procedures will apply to these Claims.
Expedited external review is available if you have a medical condition where the time frame for completion of an expedited appeal with us would reasonably be expected to seriously jeopardize your life or health, or jeopardize your ability to regain maximum function.