Examples of Appeals section in a sentence
For information about submitting an appeal, please see the Reconsiderations and Appeals section below.
No AssignmentAs discussed in more detail in the Claims and Appeals section of this booklet, most providers are aware of our claim filing requirements and will file claims for you.
Denials based on Experimental/Investigational services and supplies are Adverse Determinations and are subject to the utilization review process, including reviews by an Independent Review Organization (IRO) as described in the Complaint and Appeals section.
Any Party may appeal a dismissal using the process set forth in the Appeals section below.
The Claims and Appeals section is not part of theGroup Insurance Certificate.CLAIMS AND APPEALSPlan Benefits Provided by The Prudential Insurance Company of America 751 Broad StreetNewark, New Jersey 07102 This Group Contract underwritten by The Prudential Insurance Company of America provides insured benefits.
Members have the right to appeal coverage decisions (see Appeals section).
If we deny your request for continuity of care, you may file an appeal following the procedures described in the Claims and Appeals section of this booklet.
Denials based on Experimental/Investigational services and supplies are Adverse Determinations and are subject to the utilization review process, including reviews by an Independent Review Organization (IRO) as described in the Complaint and Appeals section of the Certificate of Coverage.
For information about submitting an appeal, please see the Appeals section below.
Both the Complainant and the Respondent have the right to appeal the outcome of the Student Conduct Review Process on the basis outlined in the applicable Student Conduct Appeals section UCF-5.010 (individual student UCF-5.013 (registered student organizations).