627.6141 Denial of claims.—Each claimant, or provider acting for a claimant, who has had a claim denied as not medically necessary must be provided an opportunity for an appeal to the insurer’s licensed physician who is responsible for the medical necessity reviews under the plan or is a member of the plan’s peer review group. The appeal may be by telephone, and the insurer’s licensed physician must respond within a reasonable time, not to exceed 15 business days.
History.—s. 7, ch. 96-223.
Section: Previous 627.609 627.610 627.611 627.612 627.613 627.6131 627.614 627.6141 627.615 627.616 627.617 627.618 627.619 627.620 627.621 NextLast modified: September 23, 2016