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Internal review definition

Internal review means the process an insurer uses to review an insured's adverse benefit determination before the adverse benefit determination is submitted for independent review.
Internal review means procedures established by a health benefit plan, pursuant to the provisions of Section 4 of this act, for an internal reevaluation of an initial decision to deny coverage of or reimbursement for a medical treatment or service that is otherwise a covered benefit, and the subsequent decision by the health benefit plan to grant or deny such coverage or reimbursement.
Internal review means a review under section 156 of the Act. O. Reg. 379/11, s. 8 (4).

Examples of Internal review in a sentence

  • Review and Make Course Corrections Internal review of data and evidence from all monitoring actions to inform decision making.

  • Appendix C: IceCube Maintenance, Operations and Data Analysis PlanThis document sets forth the plan for the organization and implementation for M&O and Data Analysis during the operations phase of IceCube.M&O and Physics Analysiso Planning Documentationo Analysis Coordinationo Internal review Processo Talks Planning DocumentationPlanning documentation is composed of this document in its entirety, which lays out the plan for M&O and data analysis of IceCube data.

  • If such evidence or information is submitted by mail, the evidence or information shall be accompanied by a written explanation of why electronic submission was not feasible.20.5(4) Internal review.

  • Internal review, self-evaluation and monitoring policy and procedures are formal processes that are carried out at regular intervals and are used for upcoming external reviews.

  • Internal review panel members must be present physically or by video or telephone conferencing to hear the Grievance.


More Definitions of Internal review

Internal review means evaluation of the performance of an Accredited Practitioner by an appropriately qualified and experienced professional person(s) internal to UnitingCare Health.
Internal review means the review of the Draft Report that will be undertaken by NBAC members, and from which recommendations for changes will arise.
Internal review means any internal investigation, conducted by the Sheriff or his designee, on a member or members of the bargaining unit, for incidents or events that arise from official acts or behaviors of the member, which could result in disciplinary action being taken, up to and including termination of employment.
Internal review means procedures established by a health
Internal review. If We deny benefits for a Prescription Drug, You must request that We consider an exception either verbally or in writing following Our notification of the denial. With Your consent, such request may be submitted on Your behalf by Your Designated Representative or by the Provider who prescribed the Prescription Drug. We will provide You with verbal notification of Our determination within 72 hours from Our receipt of Your request for a Standard Drug Exception Request or within 24 hours from Our receipt of Your request for an Expedited Drug Exception Request. We will also issue Our decision in writing no later than 48 hours after We have provided You with verbal notice of Our decision. If Your request was denied, a written notification will explain how You may request an independent review of Our internal review decision.
Internal review means a review of a decision of the Executive Director made pursuant to subregulations 3.10;
Internal review means procedures established by a health benefit plan, pursuant to the provisions of Section 4 1 of this act, for an internal reevaluation of an initial decision to deny coverage of or reimbursement for a medical treatment or service that is