Examples of Review Procedures in a sentence
External Review Procedures – In GeneralIn most cases, and except as provided in the next two sections, the Member must follow and exhaust the internal appeals process outlined above before the Member may submit a request for external review.
The notice must also provide contact information for the Commissioner’s office.3. Assignment of an IROIf a request is eligible for expedited external review, The Plan will assign an IRO pursuant to and in compliance with the independence and other selection requirements set forth in the Assignment of an IRO paragraph, Standard External Review Procedures section.
Environmental Review Procedures for Entities Assuming HUD Environmental Responsibilities (24 C.F.R. Part 58).
The assigned IRO will select Physicians or other health care providers using the same criteria as set forth in the Standard of Review paragraph in the Standard External Review Procedures, above.
A pre-notification determination cannot be appealed under the Plan’s Internal and External Claims Review Procedures.