A covered person may file a request for an external review within 60 days after the date of receipt of a notice. How will the Department determine the date of receipt of notice?
To allow for time associated with an insurer’s processing and mailing time, the Department will generally assume that a request for external review that is received within 70 days of the date that appears on the insurer’s notice of decision on second-level review was made within the statutory time limits. However, documentation of date of receipt (e.g., certified mail receipt) that is provided by the insurer or the covered person may result in a request being denied though received within 70 days or accepted though received after 70 days.
Related Questions
- A covered person may file a request for an external review within 60 days after the date of receipt of a notice. How will the Department determine the date of receipt of notice?
- How will the Department determine when a provider who requests an external review on behalf of a covered person is doing so on the authority of the covered person?
- How long does a covered person have to add missing information to a request for external review that has been found to be incomplete?
