Model Notice of Final Adverse Benefit Determination

The agencies have issued a Model Notice which may be used by plans when denying a claim after internal review under the claims and review requirements of the Affordable Care Act.

Document Excerpt


 This document serves as notice of a final internal adverse benefit determination. We have declined to provide benefits, in whole or in part, for the requested treatment or service described below. If you think this determination was made in error, you may have the right to appeal (see the back of this page for information about your appeal rights).

Link iabdmodelnotice1

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