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Section 58-17C-90 - Standard review--Time within which to notify covered person of decision--Extension of time.

58-17C-90. Standard review--Time within which to notify covered person of decision--Extension of time. The health carrier shall notify in writing the covered person or, if applicable, the covered person's authorized representative of the decision within twenty working days after the date of receipt of the request for a standard review of a grievance filed pursuant to § 58-17C-88. The time frame for notification may be varied subject to the following:
(1) Subject to subdivision (2) of this section, if, due to circumstances beyond the carrier's control, the health carrier cannot make a decision and notifies the covered person or, if applicable, the covered person's authorized representative pursuant to this section within twenty working days, the health carrier may take up to an additional ten working days to issue a written decision; and
(2) A health carrier may extend the time for making and notifying the covered person or, if applicable, the covered person's authorized representative in accordance with subdivision (1) of this section, if, on or before the twentieth working day after the date of receiving the request for a standard review of a grievance, the health carrier provides written notice to the covered person or, if applicable, the covered person's authorized representative of the extension and the reasons for the delay.

Source: SL 2003, ch 250, § 41.

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