Common use of Concurrent Reviews Clause in Contracts

Concurrent Reviews. 1. Utilization review decisions for services during the course of care (concurrent reviews) will be made, and notice provided to you (or your designee) and your Provider, by telephone and in writing, within one (1) business day of receipt of all necessary information. If we need additional information, we will request it within one (1) business day. You or Your Provider will then have 45 calendar days to submit the information. We will make a determination and provide notice to You (or Your designee) and Your Provider, by telephone and in writing, within one (1) business day of Our receipt of the information or, if We do not receive the information, within 15 calendar days of the end of the 45-day time period.

Concurrent Reviews. 1. Utilization review decisions for services during the course of care (concurrent reviews) will be made, and notice provided to you You (or your Your designee) [and your Your Provider], by telephone and in writing, within one (1) business day of receipt of all necessary information. If we We need additional information, we We will request it within one (1) business day. You or Your Provider will then have 45 calendar days to submit the information. We will make a determination and provide notice to You (or Your designee) and Your Provider, by telephone and in writing, within one (1) business day of Our receipt of the information or, if We do not receive the information, within 15 calendar days of the end of the 45-day time period.

Concurrent Reviews. 1. A. Utilization review decisions for services during the course of care (concurrent reviews) will be made, and notice provided to you You (or your Your designee) and your Your Provider, by telephone and in writing, within one (1) business day of receipt of all necessary information. If we We need additional information, we We will request it within one (1) business day. You or Your Provider will then have 45 calendar days to submit the information. We will make a determination and provide notice to You (or Your designee) and Your Provider, by telephone and in writing, within one (1) business day of Our receipt of the information or, if We do not receive the information, within 15 calendar days one (1) business day of the end of the 45-day time period.