Who notifies the provider and enrollee about the requirements of the Part D plans appeal process and the outcomes of any reconsiderations or exceptions?
A plan must provide their enrollees with information regarding their specific exception and appeals process. It is likely that you, or your patient, will need to contact the plan to find out the specific requirements and forms in order to submit an exception request. Pharmacies are also required to provide general written information on how a enrollee can request an exception and appeal. In general, the plan is responsible for notifying the provider and enrollee of the outcomes of exception and appeal requests. All negative decisions must be provided in writing to the enrollee.
Related Questions
- Who notifies the provider and enrollee about the requirements of the Part D plans appeal process and the outcomes of any reconsiderations or exceptions?
- If an appeal is granted, does the student still need to fulfill the requirements of an Educational Proficiency Plan (EPP)?
- How long does the appeal process work and what are the possible outcomes of an appeal?
