Advisor Use in Claims Dispute. Alliance shall accept Provider’s designated, North Carolina licensed, physician advisor with knowledge of the unit and care of the Member as Provider’s approved representative for a claim or prior authorization in review or dispute. The following provisions are required verbatim by NC DHHS and are incorporated into this Contract in compliance with Alliance’s Tailored Plan contract. a. Compliance with State and Federal Laws
Appears in 2 contracts
Sources: Network Participating Provider Contract, Medicaid Network Participating Provider Contract