The timeframe for a health plan to render a decision about payment for medical care or services that a member has already received is 60 calendar days.
A health plan is defined as the type of insurance that helps cover both the medical Ans surgical expenses incurred by an insured individual.
An appeal is usually sent to the insurance company concerning payment for services an insured individual already received.
The timeframe for a health plan to render a decision about payment for medical care or services that a member has already received is 60 calendar days.
This is applicable because necessary information and verification needs to be made before the commencement of any payments.
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