ARSD 20:06:53:11. Waiver of exhaustion requirement

A request for an external review of an adverse determination may be made before the covered person has exhausted the health carrier's internal grievance procedures as set forth in SDCL 58-17I-7 to 58-17I-11, inclusive, whenever the health carrier agrees to waive the exhaustion requirement. If the requirement to exhaust the health carrier's internal grievance procedures is waived under this section, the covered person or the covered person's authorized representative may file a request in writing for a standard external review as set forth in §§ 20:06:53:12 to 20:06:53:22, inclusive, or §§ 20:06:53:33 to 20:06:53:54, inclusive.