Common use of Provider Administrative Review and Appeals Clause in Contracts

Provider Administrative Review and Appeals. Where applicable, a Provider shall exhaust all Health Plan’s review and appeal rights in accordance with the Provider Manual before seeking any other remedy. Where required by Laws or Program Requirements, administrative reviews and appeals shall be subject to and resolved in accordance with administrative law.

Provider Administrative Review and Appeals. Where applicable, a Provider shall exhaust all Health Plan’s review and appeal rights in accordance with the Provider Manual before seeking any other remedyremedy except as pertains to termination or non-renewal of the Agreement. Where required by Laws or Program Requirements, administrative reviews and appeals shall be subject to and resolved in accordance with administrative law.