Common use of Ongoing Reviews Clause in Contracts

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure section of this Certificate.

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure section of this Certificate.

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure section of this Certificate.this

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure section of this Certificate.

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure Claim Procedures/Complaints and Appeals /Dispute Resolution section of this Certificate.

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure Claim Determination Procedures/Complaints And Appeals/External Independent Medical Review/Dispute Resolution section of this Certificate.

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to To seek a review, please see the Grievance Procedure Complaints and Appeal section of this the Certificate.

Ongoing Reviews. HMO conducts ongoing reviews of those services and supplies, supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Grievance Procedure Claim Procedures/Complaints and Appeals, External Review section of this Certificate.