Examples of Appeal procedure in a sentence
Appeal Procedure for Denied Claims Whenever a claim is denied, you have the right to appeal the decision.
The Appeal Procedure text must satisfy the requirements of N.J.A.C. 11:24-8.5 et seq.
If, after speaking with a Customer Service representative, You are still dissatisfied, refer to the Appeal Procedure Addendum attached to this Certificate for further steps You can take regarding Your claim.
Upon any adverse benefit determination, the Fund will notify the Claimant of this Claims Review and Appeal Procedure and its time limits.
Appeal Procedure DefinitionsAdverse Benefit Determination: A determination by BCBSNE or its Utilization Review designee, of the denial, reduction,or termination of a benefit, or a failure to provide or make payment (in whole or in part) of a benefit.