Idaho Health Carrier External Review Act Overview

<p>Dental insurance</p> Signup and view all the answers

<p>'We have denied your request for a health care service.'</p> Signup and view all the answers

<p>Plans covering vision care</p> Signup and view all the answers

<p>Consulting reports from appropriate health care professionals and other documents submitted by the health carrier or the covered person</p> Signup and view all the answers

<p>To uphold or reverse the final adverse benefit determination</p> Signup and view all the answers

<p>Having accreditation standards that are equivalent to or exceed the minimum qualifications established under Idaho code</p> Signup and view all the answers

<p>The covered person, the health carrier, and the director</p> Signup and view all the answers

<p>Maintain written records and submit a report to the director</p> Signup and view all the answers

<p>The treating provider's personal experience</p> Signup and view all the answers

<p>Only after exhausting the health carrier's internal grievance process</p> Signup and view all the answers

<p>If the covered person was enrolled in the health benefit plan at the time of service</p> Signup and view all the answers

<p>After receiving a written decision from the health carrier within 35 days</p> Signup and view all the answers

<p>Within 5 business days after completing a preliminary review</p> Signup and view all the answers

<p>Only for urgent care service requests that meet specific criteria</p> Signup and view all the answers

<p>The covered person has provided all required information for processing</p> Signup and view all the answers

<p>The release form and all required information</p> Signup and view all the answers