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What issues are eligible for external review, i.e. medical necessity, experimental / investigational, other?

April 26, 2017eligible experimental external investigational medical necessity review

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What issues are eligible for external review, i.e. medical necessity, experimental / investigational, other?

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The issues eligible for external review include all appeal decisions upholding a noncertification or a second-level grievance review decision upholding a noncertification.