Common use of Denials Clause in Contracts

Denials. i. The CONTRACTOR shall clearly document in English or Spanish, as appropriate, on a form agreed to by HSD, and communicate in writing the reasons for each denial. A “denial” is defined as a refusal by the CONTRACTOR to authorize a service requested or recommended by the member’s health care provider.

Appears in 1 contract

Sources: Medicaid Managed Care Services Agreement (Molina Healthcare Inc)

Denials. i. The CONTRACTOR shall shall: i. clearly document in English or Spanish, as appropriate, on a form agreed to by HSD/MAD, and communicate in writing the reasons for each denialdenial to the requesting provider and the member. A “denial” is defined as a refusal by the CONTRACTOR to authorize a service requested or recommended by the member’s health care provider.;

Appears in 1 contract

Sources: Medicaid Managed Care Services Agreement (Molina Healthcare Inc)

Denials. i. The CONTRACTOR shall clearly document in English or Spanish, as appropriate, on a form agreed to by HSD, and communicate in writing the reasons for each denial. A "denial" is defined as a refusal by the CONTRACTOR to authorize a service requested or recommended by the member’s 's health care provider.

Appears in 1 contract

Sources: Medicaid Managed Care Services Agreement (BHC Physician Services of Kentucky LLC)