How Does The External Appeal Agent Get My Medical Records And Treatment Information?
The external appeal agent will send a request for information to you, your health plan, and your physician / health care provider. Your health plan is required to send your medical records to the external appeal agent. However, there may be times when your health plan does not have your complete medical record but your physician / health care provider does. It is important that you work with your physician / health care provider to make sure that the medical records and treatment information your physician / health care provider has will be sent to the external appeal agent. An external appeal agent is required to make a decision on your appeal even if all your records are not submitted.
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