What are the specific procedural requirements for filing an expedited external review after an adverse determination on an out-of-network surgical claim?
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The searches the AI actually ran for this prompt.
SEED QUERY
What are the specific procedural requirements for filing an expedited external review after an adverse determination on an out-of-network surgical claim?
2 real searches · 1 real-search pass
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Classifying 2 queries…
Searches and sources
ChatGPT2 real searches · gpt-6
ACA expedited external review 45 CFR 147.136 procedures urgent care adverse benefit determination out-of-network surgical claim Google ↗
West Virginia external review expedited health insurance adverse determination procedures insurance commissioner Google ↗
- West Virginia Code of State Rules, Series 114-97, Section 114-97-6 - Standard External Review | West Virginia Code of State Rules · regulations.justia.com
- West Virginia Code of State Rules, Series 114-97, Section 114-97-7 - Expedited External Review | West Virginia Code of State Rules · regulations.justia.com
- 45 CFR § 147.136 - Internal claims and appeals and external review processes. | Electronic Code of Federal Regulations (e-CFR) | US Law · law.cornell.edu
- Dept. of Health and Human Services § 147.136 · govinfo.gov
Queries
2 queries · click a column to sort
| Query / type | Search | Intent | Query class | Routing format | Cluster | Freq ↓ | Weight |
|---|---|---|---|---|---|---|---|
ACA expedited external review 45 CFR 147.136 procedures urgent care adverse benefit determination out-of-network surgical claim OBSERVED | Google ↗ AI Mode ↗ | — | — | — | — | 1x of 1 | |
West Virginia external review expedited health insurance adverse determination procedures insurance commissioner OBSERVED | Google ↗ AI Mode ↗ | — | — | — | — | 1x of 1 |