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External Appeals of Adverse Determinations of Health Care Plans | Midpage
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New York Codes, Rules and Regulations
Title 11
Chapter XVIII
Part 410
External Appeals of Adverse Determinations of Health Care Plans
Insurance
410.1
Preamble.
410.2
Definitions.
410.3
Standard description of the external appeal process.
410.4
Certification of external appeal agents.
410.5
Certification requirements.
410.6
Conflict of interest.
410.7
Screening of requests for external appeal.
410.8
Random assignment of external appeals.
410.9
Responsibilities of health care plans.
410.10
Responsibilities of certified external appeal agents.
410.11
Insured rights and responsibilities.
410.12
Confidentiality.
410.13
Audits and examinations.