Review Process A/E's Work Product will be reviewed by County under its applicable technical requirements and procedures, as follows:
Claims Review Population A description of the Population subject to the Claims Review.
Claims Review Objective A clear statement of the objective intended to be achieved by the Claims Review.
Interview Process Interviews will take place over a period of ninety (90) days. The interviews both of bargaining unit employees and of managers will be conducted jointly by Union/Industry members of the Technical Committee (or designates).
Claims Review Findings a. Narrative Results.
Additional RO Review Criteria (1) In addition to the requirements in Subparagraph 34A, the RO must:
Claims Review Methodology a. C laims Review Population. A description of the Population subject to the Quarterly Claims Review.
Review Protocol A narrative description of how the Claims Review was conducted and what was evaluated.
Readiness Review Includes all plans to be implemented in one or more Service Areas on the anticipated Operational Start Date. At a minimum, the HMO shall, for each HMO Program:
Review Procedure If the Plan Administrator denies part or all of the claim, the claimant shall have the opportunity for a full and fair review by the Plan Administrator of the denial, as follows:
