WAC 284-43-3190

WAC 284-43-3190. Concurrent expedited review of adverse benefit determinations

Last amended: 2016Year: 2026Length: 154 wordsOfficial source
(1) "Concurrent expedited review" means initiation of both the internal and external expedited review simultaneously to: (a) Review of a decision made under WAC 284-43-2000 ; or (b) Review conducted during a patient's stay or course of treatment in a facility, the office of a health care professional or other inpatient or outpatient health care setting so that the final adverse benefit determination is reached as expeditiously as possible. (2) A carrier must offer the right to request concurrent expedited internal and external review of adverse benefit determinations. When a concurrent expedited review is requested, a carrier may not extend the timelines by making the determinations consecutively. The requisite timelines must be applied concurrently. (3) A carrier may deny a request for concurrent expedited review only if the conditions for expedited review in WAC 284-43-3170 are not met. A carrier may not require exhaustion of internal review if an appellant requests concurrent expedited review.
WAC 284-43-3190: WAC 284-43-3190. Concurrent expedited review of adverse benefit determinations | Justis AI