Common use of Expedited Appeal Process Clause in Contracts

Expedited Appeal Process. CHA PACE has an expedited appeal process for situations in which you and/or your caregiver/ family believe that your life, health or ability to regain maximum function would be seriously jeopardized, absent provision of the service in dispute. • CHA PACE will respond to the appeal in the same manner as described in the standard appeal process, as expeditiously as the participant’s health condition requires, but no later than 72 hours after it receives the appeal. • CHA PACE may extend the 72-hour time frame by up to 14 calendar days for either of the following reasons: » You request an extension » CHA PACE justifies to the MassHealth the need for additional information and how the delay is in your best interest In the event that the determination is in your favor, CHA PACE will furnish the disputed service(s) as expeditiously as the participant’s health condition requires.

Expedited Appeal Process. CHA PACE has an expedited appeal process for situations in which you and/or your caregiver/ family believe that your life, health health, or ability to regain or maintain maximum function would be seriously jeopardized, absent provision of the service in dispute. • CHA PACE will respond to the appeal in the same manner as described in the standard appeal process, as expeditiously quickly as the participant’s health your condition requires, but no later than 72 72-hours after it receives we receive the appeal. • CHA PACE may extend the 72-hour time frame by up to 14 calendar days for either of the following reasons: » You request an extension extension; or » CHA PACE justifies to the MassHealth the need for additional information and how the delay is in your best interest In the event that the determination is in your favor, CHA PACE will furnish the disputed service(s) as expeditiously as the participant’s health condition requiresinterest.