Examples of Experimental or Investigative in a sentence
If an Insured Person has an Adverse Determination based on an Experimental or Investigative Treatment, the provision entitled External Review of Denial of Experimental or Investigative Treatment will apply.
External Review of Denial of Experimental or Investigative Treatment Within sixty (60) days after the date of receipt of a notice of an Adverse Determination or final Adverse Determination that involves a denial of coverage based on a determination that the health care service or Treatment recommended or requested is Experimental or Investigational, an Insured Person or the Insured Person's authorized representative may file a request for external review with the Commissioner of Insurance.
APPEALS PROCEDURE 35Internal Review Procedure 35External Review Procedure 37External Review of Denial of Experimental or Investigative Treatment 38 INSURANCE INFORMATION SCHEDULE POLICYHOLDER: William Penn University POLICY NUMBER: AIIC1718IASHIP49Oskaloosa, Iowa EFFECTIVE DATE: August 01, 2017 TERMINATION DATE: August 01, 2018 The Policy Year runs from the Policy Effective date until the Policy Termination Date.
Certain Treatments and medications, such as vitamins, herbs, aspirin, cold remedies, medicines, Experimental or Investigative drugs, or medical Supplies even when recommended by a Physician, do not qualify as Prescription Drugs.
Services or supplies that the Insurer considers to be Experimental or Investigative.