CHAPTER 58-17I

GRIEVANCE PROCEDURE

58-17I-1    Definitions.

58-17I-2    Health benefit plan defined.

58-17I-3    Urgent care request defined.

58-17I-4    Register of grievances required--Information to be compiled--Maintenance.

58-17I-5    Report to director required--Contents.

58-17I-6    Grievance procedures--Filing--Certificate of compliance--Contact information.

58-17I-7    Review of adverse determination--Time for filing--Designation and notice of reviewers--Scope of review.

58-17I-8    Rights of covered person or authorized representative on review--Access to documentation.

58-17I-9    Time for decision and notice--Calculation of time periods.

58-17I-10    Procedures for providing new or additional evidence.

58-17I-11    Issuance of decision--Required contents.

58-17I-12    Expedited review for adverse determinations involving urgent care requests--Appointment of peers for review.

58-17I-13    Transmission of necessary information for certain expedited reviews.

58-17I-14    Expedited review decision not initial determination for benefits--Notification--Time periods--Continuation of service involving concurrent review urgent care requests.

58-17I-15    Expedited review decision--Notification--Required contents.

58-17I-16    Promulgation of rules.