Examples of Notice of Adverse Benefit Determination in a sentence
The Contractor is required send out a Notice of Adverse Benefit Determination to the Enrollee and the Provider on the day that the timeframe expires.
A Notice of Adverse Benefit Determination is also used to tell you if your grievance, appeal, or expedited appeal was not resolved in time, or if you did not get services within the mental health plan’s timeline standards for providing services.
The Contractor shall provide a Notice of Adverse Benefit Determination to the Aggrieved Person at the time the Contractor determines the timeframe for resolving the Appeal or Grievance will not be met.
A Notice of Adverse Benefit Determination is a letter that your mental health plan will send you if it makes a decision to deny, limit, reduce, delay, or end services you and your provider believe you should get.
A Notice of Adverse Benefit Determination is also used to tell you if your grievance, appeal, or expedited appeal was not resolved in time, or if you didn’t get services within the Drug Medi-Cal Organized Delivery System county’s timeline standards for providing services.
The Contractor shall provide a Notice of Adverse Benefit Determination to the Enrollee at the time either the Enrollee or provider informs the Contractor that the provider failed to meet the performance benchmarks for appointment waiting times found in Article 10.2.6.
You have a right to receive a written Notice of Adverse Benefit Determination.
The Aggrieved Person may request an expedited Appeal within 60 calendar days from the date on the Contractor’s written Notice of Adverse Benefit Determination.
The Contractor shall provide a Notice of Adverse Benefit Determination to the Enrollee at the time either the Enrollee or Provider informs the Contractor that the Provider failed to meet the performance standards for offering face-to- face appointment waiting times found in Article 10.4.
The Aggrieved Person may request an oral or written Appeal within 60 calendar days from the date on the Contractor’s written Notice of Adverse Benefit Determination.