NV HMO Appeal – Notice Requirements for Adverse Determinations
October 13, 2021 9:55 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Nevada Division... View more
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NV HMO Appeal – No Authorization for ER Services and Care
October 13, 2021 9:53 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Nevada Division... View more
KS HMO Script – Refund Recoupment
October 13, 2021 9:51 amASK YOURSELF: How many days after payment, did the HMO plan request the refund? Why did the plan request the... View more
NV HMO Appeal – Maternity Coverage
October 13, 2021 9:50 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Nevada Division... View more
OH HMO Appeal – No Authorization for ER Services and Care
October 13, 2021 9:49 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Ohio Department... View more
OH HMO Appeal – Untimely Payment
October 13, 2021 9:45 amURGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the Ohio... View more
KS HMO Script – Poststabilization Timeframe
October 13, 2021 9:39 amASK YOURSELF: When was the patient stabilized in the emergency room or admitted as an inpatient? Was the admission during... View more
RI HMO Appeal – Interest Owed on Late Claims
October 13, 2021 9:32 amURGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the Office... View more
RI HMO Appeal – Maternity Coverage
October 13, 2021 9:31 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Office of... View more
RI HMO Appeal – Medical Necessity – Qualified Reviewers
October 13, 2021 9:29 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the Office of... View more