Full and fair review. The Plan or the Plan’s Designee shall allow a Member, the Member’s Representative or Health Care Provider acting on behalf of the Member to review the claim file and to present evidence and written testimony as part of the internal claims and Appeals and Grievances process. Specifically, in addition to the requirements of paragraphs G.2.a through c herein, the following apply:
Appears in 6 contracts
Samples: Individual Enrollment Agreement, Individual Enrollment Agreement, content.carefirst.com
Full and fair review. The Plan or the Plan’s 's Designee shall allow a Member, the Member’s 's Representative or Health Care Provider acting on behalf of the Member to review the claim file and to present evidence and written testimony as part of the internal claims and Appeals and Grievances process. Specifically, in addition to the requirements of paragraphs G.2.a through c herein, the following apply:
Appears in 2 contracts
Samples: myahpcare.com, www.gradymgt.com
Full and fair review. The Plan or the Plan’s Plan‟s Designee shall allow a Member, the Member’s Member‟s Representative or Health Care Provider acting on behalf of the Member to review the claim file and to present evidence and written testimony as part of the internal claims and Appeals and Grievances process. Specifically, in addition to the requirements of paragraphs G.2.a through c herein, the following apply:
Appears in 1 contract
Samples: insurance.maryland.gov
Full and fair review. The Plan or the Plan’s 's Designee shall allow a Member, the Member’s 's Representative or Health Care Provider acting on behalf of the Member to review the claim file and to present evidence and written testimony as part of the internal claims and Appeals and or Grievances process. Specifically, in addition to the requirements of paragraphs G.2.a through c herein, the following apply:: SAMPLE
Appears in 1 contract
Samples: content.carefirst.com
Full and fair review. The Plan or the Plan’s Designee shall allow a Member, the Member’s Representative or Health Care Provider acting on behalf of the Member to review the claim file and to present evidence and written testimony as part of the internal claims and Appeals and Grievances process. Specifically, in addition to the requirements of paragraphs G.2.a through c herein, the following apply:
Appears in 1 contract
Samples: Evergreen Individual Plan Agreement
