Standard Review. The Parties shall have a standard review period of thirty (30) calendar days for commenting on all documents, resource evaluations of significance, treatment plans, and specifications which are developed under the terms of this Agreement, from the date they are sent by BOEM via electronic media (email or secure website).
Standard Review. We will review your request and issue a determination to you, your designee, prescribing physician or other prescriber, within 72 hours following receipt of your request.
Standard Review. The signatories shall have a standard review period of thirty (30) calendar days for commenting on all documents which are developed under the terms of this Agreement, from the date they are received by the signatory. This includes technical reports of historic property identification and eligibility determinations, as well as agency findings.
Standard Review. 1. The standard review process is described in 36 CFR Parts 800.3 through 800.6.
Standard Review. The claimant may request a review by an Independent Review Organization (IRO) of an Adverse Benefit Determination or Final Internal Adverse Benefit Determination which was based on a judgment as to the Medical Necessity, appropriateness, health care setting, level of care, or effectiveness of the health care service or treatment. The claimant must exhaust the internal appeal process prior to a request for External Review. The request must be submitted in writing within four (4) months after the date of receipt of a notice of a Final Internal Adverse Benefit Determination. The Covered Person will be required to authorize the release of any of his or her protected health information, including medical records, which may be needed for the purposes of the External Review. The request for an External Review may be submitted electronically, by facsimile, or U.S. mail, as stated on the Final Internal Adverse Benefit Determination notice (letter). The request should be submitted to: Nebraska Department of Insurance P.O. Box 82089 Lincoln, NE 68501-2089 xxx.xxx.xxxxxxxx.xxx Upon receipt of a request for an External Review, the Nebraska Department of Insurance (NDOI) will forward the request to BCBSNE to conduct a preliminary review to determine if it is complete and whether it is eligible for External Review, consistent with applicable law. BCBSNE will conduct this preliminary review within 5 business days of receipt, and notify the NDOI and the claimant of the outcome within one business day. If it is determined that the request is not complete, or is not eligible for External Review, the claimant will be notified of the reason for ineligibility, or advised of the information needed to make the request complete. The NDOI may determine that the request is eligible notwithstanding BCBSNE’s determination, consistent with state law. If the request is eligible for External Review, the NDOI will assign an IRO to conduct the review, and notify BCBSNE and the claimant of the assignment within one business day. BCBSNE will forward all documentation and information considered in making the initial Adverse or Final Adverse Benefit Determination, including a summary of the Claim and explanation for the determination to the IRO within 5 business days. The claimant will also be allowed an opportunity to submit additional information for consideration by the IRO. The IRO shall provide BCBSNE with any information submitted by the claimant, to allow BCBSNE an opportunity to recons...
