New Internal and External Review Requirements for Claims and Appeals Procedures under Reform

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New Internal and External Review Requirements for Claims and Appeals Procedures under Reform
Jones Day

[Guidance Overview]
Aug. 24, 2010

Excerpt: Effectively, these new requirements mean that group health plans must review appeals immediately upon receipt to allow for potential interim 'mini appeals' prior to the deadline for responding to the appeal. In addition, plans that currently allow for two levels of appeal might consider reducing that to one to maximize the time allowed for the above process to take place.

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