Remedies if Process. “Deemed Exhausted” a. If we continue to deny the payment, coverage, or service requested or you do not receive a timely decision, you may be able to request an external review of your Claim by an independent third party, who will review the denial and issue a final decision. You may contact ▇▇▇▇▇’s Member Engagement Center at ▇-▇▇▇-▇▇▇-▇▇▇▇ with any questions on your rights to external review. Please understand that if you want to be informed about the legal remedies that may be available to you and whether they are a better option for you than seeking independent external review, you should consult a lawyer of your choice. AvMed cannot provide you with legal advice. We can only explain the procedures for obtaining independent external review.
Appears in 7 contracts
Sources: Medical and Hospital Service Contract, Medical and Hospital Service Contract, Medical and Hospital Service Contract
Remedies if Process. “Deemed Exhausted”
a. If we continue to deny the payment, coverage, or service requested or you do not receive a timely decision, you may be able to request an external review of your Claim by an independent third third-party, who will review the denial and issue a final decision. You may contact ▇▇▇▇▇’s Member Engagement Center at ▇-▇▇▇-▇▇▇-▇▇▇▇ with any questions on your rights to external review. Please understand that if you want to be informed about the legal remedies that may be available to you and whether they are a better option for you than seeking independent external review, you should consult a lawyer of your choice. AvMed cannot provide you with legal advice. We can only explain the procedures for obtaining independent external review.
Appears in 3 contracts
Sources: Medical and Hospital Service Contract, Medical and Hospital Service Contract, Medical and Hospital Service Contract
Remedies if Process. “Deemed Exhausted.”
a. If we continue to deny the payment, coverage, or service requested or you do not receive a timely decision, you may be able to request an external review of your Claim by an independent third party, who will review the denial and issue a final decision. You may contact ▇▇▇▇▇’s Member Engagement Center at ▇-▇▇▇-▇▇▇-▇▇▇▇ with any questions on your rights to external review. Please understand that if you want to be informed about the legal remedies that may be available to you and whether they are a better option for you than seeking independent external review, you should consult a lawyer of your choice. AvMed cannot provide you with legal advice. We can only explain the procedures for obtaining independent external review.
Appears in 2 contracts
Sources: Non Group Medical and Hospital Service Contract, Non Group Medical and Hospital Service Contract
Remedies if Process. “Deemed Exhausted”
a. If we continue to deny the payment, coverage, or service requested or you do not receive a timely decision, you may be able to request an external review of your Claim by an independent third party, who will review the denial and issue a final decision. You may contact ▇▇▇▇▇AvMed’s Member Engagement Center at ▇-▇▇▇-▇▇▇-▇▇▇▇ with any questions on your rights to external review. Please understand that if you want to be informed about the legal remedies that may be available to you and whether they are a better option for you than seeking independent external review, you should consult a lawyer of your choice. AvMed cannot provide you with legal advice. We can only explain the procedures for obtaining independent external review.
Appears in 1 contract