31 U.S.C § 3902 (a-c)
May 15, 2020 3:27 pm(a) Under regulations prescribed under section 3903 of this title, the head of an agency acquiring property or service from... View more
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29 CFR §2560.503-1 (g)(1)
May 5, 2020 9:23 am(g) Manner and content of notification of benefit determination. (1) Except as provided in paragraph (g)(2) of this section, the... View more
42 CFR §422.590(g)(2)
May 5, 2020 9:22 am(g) Who must reconsider an adverse organization determination. (2) When the issue is the MA organization’s denial of coverage based... View more
MA Script – Medical Necessity – Qualified Reviewers
May 5, 2020 9:19 amASK YOURSELF: Who denied the claim? What is the professional’s license number with the State Medical Board? Were they a... View more
ERISA Script – Medical Necessity – Qualified Reviewers
May 5, 2020 9:17 amASK YOURSELF: Who denied the claim? Were they a licensed physician or a licensed health care professional who is competent... View more
ERISA Appeal – Medical Necessity – Qualified Reviewers
May 5, 2020 9:14 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Department of... View more
ERISA Affidavit – Medical Necessity – Qualified Reviewers
May 5, 2020 9:09 amAFFIDAVIT OF COMPLIANCE Medical Necessity Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
MA Affidavit – Medical Necessity – Qualified Reviewers
May 5, 2020 9:07 amAFFIDAVIT OF COMPLIANCE Medical Necessity Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
MA Appeal – Medical Necessity – Qualified Reviewers
May 5, 2020 8:55 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Centers for... View more