What is the turnaround time for the Insurer to implement the IROs decision to overturn a noncertification decision?
For a Standard Review, NCGS 58-50-80(l) states “Upon receipt of a notice of a decision under subsection (k) of this section reversing the noncertification appeal decision or second-level grievance review decision, the insurer shall within three business days reverse the noncertification appeal decision or second-level grievance review decision that was the subject of the review and shall provide coverage or payment for the requested health care service or supply that was the subject of the noncertification appeal decision or second-level grievance review decision.
Related Questions
- What is the turnaround time for the Insurer to implement the IROs decision to overturn a noncertification decision?
- What is the expected turnaround time for a decision given a complete prior authorization submission?
- What happens if an insurer disagrees with the IROs decision to overturn a noncertification?
