Common use of Concurrent Care Clause in Contracts

Concurrent Care. If the Claims Administrator has approved an ongoing course of treatment to be provided over a period of time or number of treatments and the Claims Administrator makes a decision to reduce or terminate such course of treatment (other than by plan amendment or plan termination) before the end of the period of time or number of treatments, then the Claims Administrator will notify the claimant sufficiently in advance of the reduction or termination of the benefit to allow him or her to appeal and obtain a decision on review before the benefit is reduced or terminated. If the Claims Administrator receives a request by the claimant to extend beyond the approved period of time or approved number of treatments a course of treatment that qualifies as "urgent care" , the Claims Administrator will notify the claimant of its determination no later than 24 hours after receipt of the claim, provided the claim is made at least 24 hours before the course of treatment otherwise is scheduled to terminate.