Expedited Resolution. An expedited review by the Contractor of a Contractor Adverse Benefit Determination.
Expedited Resolution i. If the appeal was heard first through the Contractor appeal process DHCS shall reach a decision within 3 working days from agency receipt of a hearing request for a denial of a service that meets the criteria for an expedited appeal process but was not resolved using the Contractor’s expedited appeal timeframes, or
Expedited Resolution. The Contractor shall establish and maintain an expedited review process for appeals where either the Contractor or the enrollee’s provider determines that the time expended in a standard resolution could seriously jeopardize the enrollee’s life or health or ability to attain, maintain, or regain maximum function. The Contractor shall ensure that punitive action is neither taken against a provider that requests an expedited resolution nor supports an enrollee’s appeal. In instances where the enrollee’s request for an expedited appeal is denied, the appeal must be transferred to the timeframe for standard resolution of appeals. The Contractor shall issue decisions for expedited appeals as expeditiously as the enrollee’s health condition requires, not exceeding three (3) working days from the initial receipt of the appeal. The Contractor may extend this timeframe by up to an additional fourteen (14) calendar days if the enrollee requests the extension or if the Contractor provides evidence satisfactory to the Division that a delay in rendering the decision is in the enrollee’s interest. For any extension not requested by the enrollee, the Contractor shall provide written notice to the enrollee of the reason for the delay. The Contractor shall make reasonable efforts to provide the enrollee with prompt verbal notice of any decisions that are not resolved wholly in favor of the enrollee and shall follow-up within two (2) calendar days with a written notice of action. All decisions to appeal must be in writing and shall include, but not be limited to, the following information:
Expedited Resolution. An expedited review by the Contractor of a Contractor Adverse Benefit Determination within three (3) calendar days after the Contractor receives the request, which may extended by up to fourteen (14) days.
Expedited Resolution. If a Dispute arises because Equifax believes that Critical Service Levels are not being met or that such Dispute relates to (i) matters that materially and adversely impact its business operations or (ii) compliance with applicable laws, and either party initiates the dispute resolution provisions set forth in Articles 12 and 13 for such Dispute, the time period set forth in Section 12.01 shall be changed to twenty-four (24) hours and either party may elect to bypass the Services Oversight Committee as provided in Section 12.02 and refer the Dispute directly from the Account Executives to senior management as provided in Section 12.03, and the thirty (30) business day period in Section 12.03 shall be reduced to fifteen (15) days. Except as expressly modified by this Section 12.04, all other provisions of Articles 12 and 13 shall apply to a Dispute.
Expedited Resolution. Prior to the filing of a Grievance, nothing contained in this Article shall prevent any nurse, with or without a Union Representative, from informally and verbally presenting and resolving any matter which otherwise might result in the filing of a Grievance. In the event the matter is not resolved in the manner described in this Section 24.2, the nurse and/or the Union Xxxxxxx may present a Grievance in accordance with Section 24.4 below.
Expedited Resolution. An expedited review by Contractor of a Contractor Action within three (3) business days after the Contract receives the request, which may extended by up to fourteen (14) days.
Expedited Resolution. If a Dispute arises (a) prior to the Production Phase or (b) at any time if Rxxxx believes that Service Levels are not being met or that such Dispute relates to (i) matters that materially and adversely impact either party’s business operations or (ii) compliance with applicable laws, and either party initiates the dispute resolution provisions set forth in Article 12 for such Dispute, the time period set forth in Section 12.01 shall be changed to twenty-four (24) hours in Section 12.03. In such event, either party may elect to bypass the Services Oversight Committee as provided in Section 12.02 and refer the Dispute directly from the Account Executives to senior management as provided in Section 12.03, and the fourteen (14) day and five (5) day periods in Section 12.03 shall be reduced to seven (7) and three (3) days, respectively. Except as expressly modified by this Section 12.04, all other provisions of Articles 12 and 13 shall apply to a Dispute.
Expedited Resolution. Any dispute stated in this Agreement to be resolved pursuant to this Section 24.4 (“Expert Committee Dispute”) shall be resolved as follows:
