In compliance with the guidelines, the period from March 1, 2020, to 60 days after the announced end of the National Emergency will not count towards the deadline to request an external review. The timeline to file a request for an external review will be suspended. Outcome – The claimant has until the end of the National Emergency, plus 60 days to file the appeal. The end of the 180-day timeline is March 1, 2020. Situation – The adverse decision is received by the claimant on Sept. Because the timeline for appealing expired before the effective date of these DOL guidelines, the normal timeframes apply and the appeal submitted on Mais not timely. Outcome – The rules to suspend the timeline for appealing a decision do not apply because the appeal should have been filed by Nov. The claimant files an appeal on March 24, 2020. Situation – The adverse decision is received by the claimant on June 1, 2019. Until further notice, we will accept as timely all valid appeals of adverse benefit notifications dated on or after Sept. In compliance with the guidelines, the period from Mato 60 days after the announced end of the National Emergency will not count towards the deadline to submit an appeal. The 180-day timeline for appealing an adverse benefit determination on a claim has been suspended as well. Outcome – If the National Emergency were over on June 1, 2020, the 180-day timeline to file this claim would start 60 days later, on July 31. Situation (assume 180-day timely filing rule) – The date of service was March 1, 2020 On July 31, one day remains to file the claim. If the National Emergency were over on June 1, 2020, 60 days later is July 31, 2020. Outcome – The time to file this claim is suspended starting on March 1, 2020, until 60 days after the National Emergency is declared over. The claim entered day 179 of the 180-day timeline on Feb. Situation (assume 180-day timely filing rule) – Service was rendered on Sept. Outcome – The rules to suspend timely filing do not apply. Situation (assume 180-day timely filing rule) – The time for a claim to fulfill the timely file rule expired on Feb. To help providers and individuals meet timely filing rules, the period from Mato 60 days after the announced end of the National Emergency will not count towards timely filing requirements. The date within which claimants may file a request for external review after receiving an adverse determination.The date within which claimants may file an appeal of adverse benefit determination.The date within which individuals may file a claim.In compliance with the guidelines, between Maand 60 days after the announced end of the National Emergency, the following periods and dates are suspended: This is for members of all fully insured and self-funded groups that are regulated by the Employee Retirement Income Security Act (ERISA). Blue Cross and Blue Shield of Texas (BCBSTX) will follow these guidelines. underwrite products in Maryland only.As a result of the National Emergency declared on March 1, 2020, the Employee Benefits Security Administration, Department of Labor, Internal Revenue Service and the Department of the Treasury extended certain timeframes to ease the burden of maintaining benefits and compliance with notice obligations. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. are independent licensees of the Blue Cross and Blue Shield Association. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. of Maryland (used in VA by: First Care, Inc.). In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc. and Group Hospitalization and Medical Services, Inc. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc.
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