Notice of Appeal Resolution definition

Notice of Appeal Resolution means Contractor’s notification to a Member of the resolution of an Appeal described in OAR 410-141-3890.
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Notice of Appeal Resolution means written notification of an Enrollee, and a provider when applicable, of the CONTRACTOR’s resolution of an Appeal.
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Notice of Appeal Resolution means Contractor’s written decision on an Appeal denying a service request that is sent to the Member and/or the Member’s Provider. Nurse means a person licensed by the California Board of Nursing. Operations Period means the period of time in which Contractor is performing the terms of the Contract, or any extension thereto. The Operations Period begins after the Implementation Period, with the effective date beginning on the first month of operations, continuing through to the last month of capitation. Other Health Coverage (OHC) means health coverage from another entity that is responsible for all or part of the payment for a Member’s health care services. OHC may result from a health insurance policy or other contractual agreement or legal obligation to pay for health care services provided to a Member, excluding tort liability. Out-of-Network Provider means a Provider that does not have a Network Provider Agreement with Contractor.
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Examples of Notice of Appeal Resolution in a sentence

  • The plans are described more fully in Note L of Cabot’s Form 10-K for the year ended September 30, 2002.

  • The client shall pay for any charges incurred for the denied service on or after the effective date on the Notice of Action or Notice of Appeal Resolution.

  • Unless the appeal was referred to the PHP as part of an administrative hearing process, a Division member may request a Division administrative hearing not later than 45 calendar days from the date on the Notice of Appeal Resolution.

  • For all appeals, the PHP must provide written Notice of Appeal Resolution to the Division member or their representative.

  • A written hearing request must be received by the Division not later than the 45th day following the date of the Notice of Action, or if the hearing request was initiated after an appeal, not later than the 45th day following the Notice of Appeal Resolution.

  • If the appeal was referred to the PHP from the Division as part of an administrative hearing process, the PHP must immediately (within two business days) transmit the Notice of Appeal Resolution and the complete record of the appeal to the Division Hearings Unit.

  • If the appeal was made directly by the Division member or Representative, and if the Notice of Appeal Resolution was not favorable to the Division member, the PHP must: Retain a complete record of the appeal for not less than 45 days so that, if an administrative hearing is requested, the record can be submitted to the Division’s Hearings Unit within two business days of the Division’s request.Stat.

  • The Contractor shall provide a written Notice of Appeal Resolution to the affected parties with the format and language requirements found in Article 3.5.3 of this Contract.

  • The Contractor shall complete each expedited Appeal and provide a Notice of Appeal Resolution to affected parties as expeditiously as the Enrollee’s health condition requires, but no later than 72 hours after the Contractor receives the expedited Appeal request.

  • The Contractor shall make reasonable effort to provide oral notice of the expedited resolution in addition to providing a written Notice of Appeal Resolution.

Related to Notice of Appeal Resolution

  • Notice of Appeal means a notice given pursuant to Condition 6.2.

  • Informal resolution means options for resolving a formal complaint that do not involve a full investigation and adjudication. Informal resolution may encompass a broad range of conflict resolution strategies, including mediation or restorative justice.

  • Master Resolution means the Amended and Restated Master Resolution Establishing The University of Texas System Revenue Financing System adopted by the Board on February 14, 1991, as amended on October 8, 1993, and August 14, 1997.

  • Special Resolution means a resolution passed by a majority of not less than two-thirds (2/3) of the votes cast on that resolution.

  • Supplemental Resolution means any resolution or resolutions of the Trust amending, modifying or supplementing this Bond Resolution, authorizing the issuance of a Series of Refunding Bonds, or any other Supplemental Resolution adopted by the Trust pursuant to the provisions of this Bond Resolution.

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

  • Notice of Motion means a notice setting out the text of a motion, which it is proposed to move at the next relevant meeting;

  • Notice of Hearing means a notice containing the information set out in Schedule VIII;

  • Resolution shall have the meaning specified in Section 8(E).

  • Arrangement Resolution means the special resolution approving the Plan of Arrangement to be considered at the Company Meeting, substantially in the form of Schedule B.

  • Court of Appeal means the division of the Supreme Court referred to in section 7(1)(b);

  • Notice of Arbitration means the formal notice from the CONTRACTOR or the CUSTOMER to the other party referring a dispute to arbitration in accordance with the provisions of Schedule 2-9.

  • unanimous resolution means, subject to subsection (3) -

  • Series Resolution means a resolution of the Corporation authorizing the issuance of a Series of Bonds in accordance with the terms and provisions of the General Trust Indenture, adopted by the Corporation in accordance with Section 204 of the General Trust Indenture.

  • Denial notice means a board notification denying an application for the issuance or renewal of a license as required by the Act.

  • resolution plan means a plan proposed by resolution applicant for insolvency resolution of the corporate debtor as a going concern in accordance with Part II;

  • Notice of Extension has the meaning specified in Section 2.20.

  • Claims Procedure Order means the Order under the CCAA establishing a claims procedure in respect of the Applicant, as same may be further amended, restated or varied from time to time.

  • Authorizing Resolution means a resolution adopted by the Board of Directors or by an Officer or committee of Officers pursuant to Board delegation authorizing a Series of Securities.

  • Initial Resolution Period As defined in Section 2.03(b).

  • Notice of assessment means a written notice by the division, based on a citation, that the employer must pay the amount of wages, penalties, or fines assessed.

  • Notice of Revocation means, in connection with the revocation by a Beneficial Owner or its Agent Member of its Notice of Tender, a notice, substantially in the form attached to the Tender and Paying Agent Agreement, delivered by a Beneficial Owner or its Agent Member to the Tender and Paying Agent indicating an intention to revoke the tender of some or all of the VRDP Shares for sale on a Purchase Date pursuant to Section 1 of Part II of this Statement.

  • Special Resolution Regime means each of (i) the Federal Deposit Insurance Act and the regulations promulgated thereunder and (ii) Title II of the Xxxx-Xxxxx Xxxx Street Reform and Consumer Protection Act and the regulations promulgated thereunder.

  • Expedited Appeal means if a Member appeals a decision regarding a denied request for Prior Authorization (Pre-Service Claim) for an Urgent Care Claim, the Member or Member’s Authorized Representative can request an Expedited Appeal, either orally or in writing. Decisions regarding an Expedited Appeal are generally made within seventy-two (72) hours from the Plan’s receipt of the request.

  • Borrowing Resolutions are, with respect to any Person, those resolutions substantially in the form attached hereto as Exhibit D.

  • EEA Resolution Authority means any public administrative authority or any person entrusted with public administrative authority of any EEA Member Country (including any delegee) having responsibility for the resolution of any EEA Financial Institution.