DCS Comprehensive Health Plan
Notice of Adverse Benefit Determination (NOA), Notice of Extension (NOE) and Notice of Provider Restriction (NOR)
Statement/Purpose
The purpose of this policy is to define DCS Comprehensive Health Plan (DCS CHP) business standards for processing Notices of Adverse Benefit Determination (NOA), Notices of Extension (NOE) and Notices of Provider Restriction (NOR).
Authority
[Insert and link legal citations]
Definitions
[List definitions not commonly known that are specific to the policy]
Policy
[Policies are the guiding principles and/or rules that ensure consistency and compliance with DCS CHP’s mission, values and strategic goals]
Procedure
[Procedure are high-level actions that guide adherence to policy. Procedures describe the methods used to comply with policy]
References
[Insert and link referenced policies]
Related Forms
[Insert all documents, forms etc referenced within the policy] N/A
Reviewed and Revised Date (Month/Year) |
Reason for Review |
Revision Description |
|---|---|---|
|
02/2024 |
Annual Review |
Added updates based upon ACOM 103 revisions and updated reporting requirements. |
|
03/2022 |
Annual Review |
Added and revised pertinent information required for health plan integration. |
