Internal appeal means a review by an insurer of an adverse benefit determination made
Internal appeal means a review by an insurer of an adverse benefit determination made by the insurer.
Examples of Internal appeal in a sentence
Article 122 Internal appeal Students can lodge an internal appeal in accordance with article 129 against a decision to deny reasonable accommodations.
More Definitions of Internal appeal
Internal appeal a request by an Enrollee or the Enrollee’s Appeal Representative made to the Contractor for review of an Adverse Action. Inquiry – any oral or written question by an Enrollee to the Contractor’s Enrollee services department regarding an aspect of Contractor operations that does not express dissatisfaction about the Contractor.
Internal appeal means a review by an insurer of an adverse benefit determi- nation made by the insurer.
Internal appeal means an internal review by the Medicaid Program of an adverse benefit determination.
Internal appeal means an Internal Appeal to the ‘Relevant Authority’ in terms of section 74 of the Act. In the case of the NATIONAL EMPOWERMENT FUND, the ‘Relevant Authority’ is the NATIONAL EMPOWERMENT FUND Information Committee.
Internal appeal means an appeal of an adverse benefits determination made by any of the Insureds pursuant to the U.S. Department of Labor's claim procedure regulation, 29C.F.R. 2560.501-1(h) or similar claim procedures under applicable law.
Internal appeal. A request to the Contractor by a member, a member’s authorized representative or provider, acting on behalf of the member and with the member’s written consent, for review of a Contractor’s adverse benefit determination as defined in this Contract. The internal appeal is the only level of appeal with the Contractor and must be exhausted by a member or deemed exhausted according to 42 CFR § 438.408(c)(3) before the member may initiate a State fair hearing.