How quickly will insurers have to provide information on a case?
For a Standard Review, the insurer is required to deliver the requested information to the Department within three (3) business days of receipt of the Department’s written notice of the request for review and request for information. (See NCGS 58-50-80(b)(1).) If the consumer’s request for external review is accepted, the insurer or its designee utilization review organization shall provide to the assigned individual review organization (IRO), and to the covered person or authorized representative who made the request for external review on behalf of the covered person, within seven (7) days of receipt of the notice, the document and any other information considered in making the noncertification appeal decision or the second-level grievance review decision. (See NCGS 58-50-80(b)(3).
