Common use of Your Right to Appeal A Determination that A Service Is Not Medically Necessary Clause in Contracts

Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 46 contracts

Sources: Preferred Provider Organization Contract, Preferred Provider Organization Contract, Participating Provider Organization Insurance Policy

Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary, Necessary You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 13 contracts

Sources: Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract

Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary,, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 2 contracts

Sources: Dental Insurance Policy, Dental Insurance Policy

Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is does not Medically Necessarymeet Our requirements for Medical Necessity, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 1 contract

Sources: Preferred Provider Organization Contract

Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically NecessaryNecessary , You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 1 contract

Sources: Preferred Provider Organization Contract

Your Right to Appeal A Determination that A Service Is Not Medically Necessary. If We have denied coverage on the basis that the service is not Medically Necessary, You may appeal to an External Appeal Agent if You meet the requirements for an external appeal in paragraph “A” above.

Appears in 1 contract

Sources: Student Vision Insurance Policy