Common use of External Appeal Clause in Contracts

External Appeal. An Appeal, subsequent to the Contractor’s Appeal decision, to the State Fair Hearing process for Medicaid-based Adverse Benefit Determinations or the Medicare process for Medicare-based Adverse Benefit Determinations.

Appears in 3 contracts

Sources: Contract, Contract, Contract

External Appeal. An Appealappeal, subsequent to the Contractor’s Appeal appeal decision, to the State Fair Hearing process for Medicaid-based Adverse Benefit Determinations or the Medicare process for Medicare-based Adverse Benefit Determinationsadverse decisions.

Appears in 1 contract

Sources: Medicaid Managed Care Services Agreement

External Appeal. An Appeal, subsequent to the Contractor’s Appeal decision, to the State Fair Hearing process for Medicaid-based Adverse Benefit Determinations or the Medicare process for Medicare-based Adverse Benefit DeterminationsActions.

Appears in 1 contract

Sources: Contract

External Appeal. An Appeal, subsequent to the Contractor’s Appeal decision, to the State Fair Hearing process for Medicaid-based Adverse Benefit Determinations Actions or the Medicare process for Medicare-based Adverse Benefit DeterminationsActions.

Appears in 1 contract

Sources: Contract

External Appeal. An Appealappeal, subsequent to the Contractor’s Appeal Contractor appeal decision, to the State Fair Hearing process for Medicaid-based Adverse Benefit Determinations adverse decisions or the Medicare process for Medicare-based Adverse Benefit Determinationsadverse decisions.

Appears in 1 contract

Sources: Contract