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

• Contact Xxxxxxx Xxxxxx, NGB Headquarters Internal Review Office, at (000) 000-0000, DSN 000-0000, or email to xxxxxxx.x.xxxxxx.civ@xxxx.xxx for information on the Internal Review Office for a particular state.

• Availability of Other Program Information The NGB Internal Review Office in each state and territory (which reports to the USPFO) can provide information about risk assessments and audits performed by their office which may be helpful in planning the audit.

• Availability of Other Program Information The National Guard Internal Review Office in each state and territory (which reports to the USPFO) can provide information about risk assessments and audits performed by their office which may be helpful in planning the audit.

• Contact Mr. Xxxxxxx Xxxxxx, National Guard Bureau Internal Review Office, at (000) 000-0000, DSN 000-0000 or email xxxxxxx.x.xxxxxx.civ@xxxx.xxx for information on the Internal Review Office for a particular state.

More Definitions of Internal review

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 a review of an adverse

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 evaluation of the performance of an Accredited Practitioner by an appropriately qualified and experienced professional person(s) internal to UnitingCare Health.

Internal review means procedures established by a health

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