Member Appeal definition

Member Appeal means a request for a review of an action in accordance with 42 CFR 438.400, and for a person with an SMI, an appeal of an SMI eligibility determination; decisions regarding eligibility for behavioral health services, including Title XIX services, fees and waivers; assessments and further evaluations; service and treatment plans and planning decisions; and the implementation of those decisions.
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Examples of Member Appeal in a sentence

  • The most current information about your appeals process is available by contacting KFHPWA’s Member Appeal Department at the address or telephone number below.

  • Appeals should be directed to KFHPWA’s Member Appeal Department, P.O. Box 34593, Seattle, WA 98124-1593, toll-free 1-866-458-5479.

  • The Enrollee can request an expedited/urgent appeal in writing to the above address, or by calling KFHPWA’s Member Appeal Department toll-free 1-866-458-5479.

  • If the Enrollee or the Enrollee’s legal representative wishes to appeal a KFHPWA decision to deny, modify, reduce or terminate coverage of or payment for health care services, they must submit a request for an appeal either orally or in writing to KFHPWA’s Member Appeal Department, specifying why they disagree with the decision.

  • If the Member or any representative authorized in writing by the Member wishes to appeal a KFHPWA decision to deny, modify, reduce or terminate coverage of or payment for health care services, they must submit a request for an appeal either orally or in writing to KFHPWA’s Member Appeal Department, specifying why they disagree with the decision.

  • The Member can request an expedited/urgent appeal in writing to the above address, or by calling KFHPWA’s Member Appeal Department toll-free 1-866-458-5479.

  • The Member can request an expedited/urgent appeal in writing to the above address, or by calling KFHPWA’s Member Appeal Department toll-free 0-000-000-0000.

  • Appeals should be directed to KFHPWA’s Member Appeal Department, X.X. Xxx 00000, Xxxxxxx, XX 00000-0000, toll-free 0-000-000-0000.

  • You can use the Member Appeal Form, which a Customer Service Representative can provide to you, or you can send us a letter with the information requested above.

  • If the Member or the Member’s legal representative wishes to appeal a KFHPWA decision to deny, modify, reduce or terminate coverage of or payment for health care services, he/she must submit a request for an appeal either orally or in writing to KFHPWA’s Member Appeal Department, specifying why he/she disagrees with the decision.

Related to Member Appeal

  • Appeal Board means the State Charter School Appeal

  • Appeals Board means the commissioners and deputy commissioners of the Workers’ Compensation Appeals Board acting en banc, in panels, or individually.

  • Appeal Committee means the appeal committee established by the Council in terms of section 12(3)(a);

  • Member board means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government.

  • Board of appeals means the local board of appeals as created by local ordinance.

  • Board of Supervisors means the Board of Supervisors of the County.

  • Grievance Committee means the Grievance Committee of the Bar.

  • Appeals Committee means a Committee or Tribunal duly appointed by by-law to conduct hearings under this By-law;

  • Authority board means the board of directors of the state authority appointed under section 16.

  • Board of Review or “board” means the state building code board of review created by this chapter.

  • MUSL Board means the governing body of the MUSL, which is comprised of the chief executive officer of each Party Lottery.

  • Disciplinary Committee means any person or committee of persons, or any subcommittee thereof, that is author- ized by a self-regulatory organization to issue disciplinary charges, to con- duct disciplinary proceedings, to settle disciplinary charges, to impose dis- ciplinary sanctions or to hear appeals thereof.

  • Dispute Board (DB) means the person or persons named as such in the SCC appointed by agreement between the Procuring Entity and the Contractor to make a decision with respect to any dispute or difference between the Procuring Entity and the Contractor referred to him or her by the Parties pursuant to GCC Sub-Clause 46.1 (Dispute Board) hereof.

  • Member Association means any national football association affiliated to FIFA, irrespective of whether its representative team is participating in the Competition.

  • Review Board has the meaning provided in Section 2.1(f)(i) of this Commercial Shared-Loss Agreement.

  • Company Board of Directors means the board of directors of the Company.

  • Decision-maker means a person who makes a determination regarding responsibility after the investigation has concluded. The Decision-maker cannot be the same person as the Title IX Coordinator, the Investigator, or the Appellate Decision-maker.

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Retirement Committee means a committee consisting of the Company’s Vice President of Human Resources, the Director of HR Operations and the Compensation & Benefits Manager.

  • Retirement board or "board" means the retirement system's governing board provided for in 2-15-1010.

  • Appeal means a request for a review of the Floodplain Administrator's interpretation of any provision of this ordinance.

  • Architectural Control Committee means and refer to that committee constituted under Article 4 hereof for the review of Development Plans (as hereinafter defined) and other functions.

  • Review Committee or “Committee” means a committee established pursuant to rule Chapter 67-60, F.A.C.

  • Executive commissioner means the executive

  • LOCAL BOARD OF TAX REVIEW and "BOARD OF TAX REVIEW" means the entity created under Section 182.18 of this Chapter.

  • ordinary member of the committee means a member of the committee who is not an officer of the Association under Rule 21;