29 CFR §2560.503-1(f)(2)(iii)(A)

April 29, 2020 5:43 am | Published by

(A) Pre-service claims. In the case of a pre-service claim, the plan administrator shall notify the claimant of the plan’s benefit determination (whether adverse or not) within a reasonable period of time appropriate to the medical circumstances, but not later than 15 days after receipt of the claim by the plan.

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