First-level review definition

First-level review means a review process that must be exhausted through a managed care organization before an appeal hearing is granted. Once the first-level review process is complete, a notice of decision will be issued by the managed care organization and will identify further appeal rights, if applicable.
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First-level review means either a Standard Review or a Fast Review of Our initial decision. (See section 13.)
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Related to First-level review

  • Peer review means evaluation of professional services rendered by a professional practitioner.

  • First Level Support means a) delivery of standard answers to commonly recurring questions and b) assisting with application-related issues arising during day-to-day use of the system and c) first point of contact for technical questions concerning a purchased deliverable.

  • Clinical review criteria means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services.

  • Latest Level means, in respect of an Inflation Index, the latest level of such Inflation Index (excluding any "flash" estimates) published or announced by the relevant Inflation Index Sponsor prior to the month in respect of which the Substitute Index Level is being determined.

  • Performance Review means a summative evaluation of a teacher other than a beginning teacher and used to determine whether the teacher’s practice meets school district expectations and the Iowa teaching standards, and to determine whether the teacher’s practice meets school district expectations for career advancement in accordance with Iowa Code section 284.7.