Common use of Expedited Review Timing and Notification Clause in Contracts

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information information, we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information information, we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.. SAMPLE

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information information, we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary information so that we can complete the expedited review quickly. If you do not provide all of the information we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited Appeals involving involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.

Expedited Review Timing and Notification. SAMPLE For expedited Appeals, an appropriate clinical reviewer, not involved in the initial adverse determination or a subordinate of any individual ind ividual involved in the initial adverse determination, will investigate and complete expedited review of first level Appeals within 72 hours after we receive your Appeal. We will make a decision sooner if we can. It is critical that you provide all necessary neces sary information so that we can complete the expedited review quickly. If you do not provide all of the information we need to decide the Appeal, we will let you know within 24 hours after the Appeal is filed. This may delay our Appeal decision. For expedited exp edited Appeals involving (1) continued Medical Emergency services to screen or stabilize a Member, (2) Exigent Circumstances/Circumstances/ Urgent Care services, or (3) continued care under an authorized admission or course of treatment, coverage will be continued without withou t liability to the Member until the Member has been notified of the expedited Appeal decision. We may call you and your Provider to tell you our expedited Appeal decision. We will also send our written decision to you and your Provider within two business days after calling you.