Common use of Standard External Review Clause in Contracts

Standard External Review. Within four months after the date of receipt of a notice of an adverse determination or final adverse determination, a member or the member’s authorized representative may file a request for an external review with the Director. Within one business day after the date of receipt of a request for external review, the Director shall send a copy of the request to us. The addresses for the Director of Insurance follow: (▇▇▇) ▇▇▇-▇▇▇▇ Fax number ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇.▇▇▇ ▇▇▇▇▇://▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇▇▇▇▇▇.▇▇▇/▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ Within five business days following the date of receipt of the external review request, we shall complete a preliminary review of the request to determine whether:

Appears in 4 contracts

Sources: Evidence of Coverage, Evidence of Coverage, Evidence of Coverage