Common use of An Appeal Clause in Contracts

An Appeal. (C) A request for an External Appeal. In each of these review processes, Your notice to Us is considered to be filed on the date We first receive it orally or in writing. Detailed information on how to submit all of the above may be found in this Contract, on Our website, in newsletters, and in medical management determination letters sent to Enrollees when a Health Service is denied. At least annually in a newsletter, We notify Enrollees about the Grievance and Appeal process and the availability of External Appeals. Neither You nor Your Designated Representative will be subject to retaliation from Us for exercising Your rights to any of the review processes described in this Article. Also, We may not take any action against a Provider solely on the basis that the Provider represents You in any of the review processes described in this Article.