Form and Manner of Request

(1) Each carrier or utilization review organization shall adopt a process to accept grievances by telephone, in person, by mail, or by electronic means, provided that an oral grievance made by the insured or the authorized representative shall be reduced to writing by the carrier and a copy thereof forwarded to the insured by the carrier or utilization review organization within 48 hours of receipt, except where this time limit is waived or extended by mutual written agreement of the insured or the insured's authorized representative and the carrier. (2) Each grievance filed pursuant to 958 CMR 3.300 through 3.314 that requires the review of medical records shall include the signature of the insured or the insured’s authorized representative on a form provided within 48 hours of receipt of the grievance by the carrier authorizing the release of medical and treatment information relevant to the grievance to the carrier or utilization review organization, consistent with state and federal law. The carrier shall request this authorization from the insured when necessary for requests reduced to writing by the carrier and for any written requests lacking an authorization. The carrier or utilization review organization shall establish a process to deliver and accept the medical release form to the insured or the insured’s authorized representative by electronic means, which shall include, but not be limited to, delivery to a designated email address or in an online consumer portal. The insured and the authorized representative shall have access to any medical information and records relevant to the grievance relating to the insured which is in the possession of the carrier and under its control.