Grievance Decision definition

Grievance Decision means a determination accepting or denying the basis or requested remedy of the grievance.

Grievance Decision means a final determination by the Plan that arises from a Grievance. Health Advocacy Unit means the Health Education and Advocacy Unit in the Division of Consumer Protection of the Office of the Attorney General established under Title 13, Subtitle 4A of the Commercial Law Article, Annotated Code of Maryland.

Grievance Decision means a final determination by Delta Dental that arises from a Grievance filed with Delta Dental under its internal Grievance process regarding an Adverse Decision concerning an Enrollee.

Examples of Grievance Decision in a sentence

• If our review of a Grievance, including an expedited Grievance, results in denial, we will send you and your Authorized Representative written notice of our Grievance Decision within the time frame stated above.

• If the grievant is dissatisfied with the Step 1 Decision, the grievant may file a Step 2 Grievance with the appropriate Step 2 Receiving Official within 30 days of receiving the Step 1 Grievance Decision.

• If we uphold the adverse determination, the denial notification will include a Notice of Grievance Decision.

• The Notice of Grievance Decision will include the appropriate information specified for the Notice of Adverse Decision above and will include that the Health Advocacy Unit is available to assist you or your representative in filing a complaint with the Insurance Commissioner.

• An Enrollee, an Enrollee’s Representative, or the attending dentist has a right to file a Complaint with the Commissioner within four (4) months after receipt of Delta Dental’s Grievance Decision.

More Definitions of Grievance Decision

Grievance Decision means a final determination by the Plan that arises from a Grievance.

Grievance Decision means a final determination by Us that arises from a Grievance filed with Us through Our Grievance procedure regarding an Adverse Decision.

Grievance Decision means a final determination by a carrier or private review agent that arises from a grievance filed with the carrier or private review agent under its internal grievance process regarding an adverse decision concerning a member or patient.

Grievance Decision means our final determination after a review of a grievance regarding an adverse decision.

Grievance Decision means a final determination by the Company that arises from a grievance filed with the Company through our grievance procedure regarding an adverse decision concerning a Member.

Grievance Decision. A final determination by Health Plan that arises from a Grievance filed with us under our internal grievance process regarding an Adverse Decision concerning a Member.

Grievance Decision means a final determination by Guardian that arises from a grievance filed with Guardian under its internal grievance process regarding an adverse decision concerning the covered person.