Emergency Care Requirements. The Health Plan shall submit to the Agency for review and final determination all denied Appeals from behavioral health care providers and out-of-plan, non-participating Behavioral Health Care Providers for denied Emergency Behavioral Health Service claims. The provider, whether a participating provider or not, must submit the denied Appeal to the Agency within ten (10) days after receiving notice of the Health Plan's final Appeal determination.
Appears in 2 contracts
Sources: Standard Contract (Wellcare Health Plans, Inc.), Standard Contract (Wellcare Health Plans, Inc.)