ORGANIZATIONAL DETERMINATION

What is ORGANIZATIONAL DETERMINATION?

ORGANIZATIONAL DETERMINATION meaning A health plan’s decision on whether to pay all or part of a bill, or to give medical services, after you file an appeal. If the decision is not in your favor, the plan must give you a written notice. This notice must give a reason for the denial and a description of steps in the appeals process. (See Appeals Process.)

 

reference: Centers for Medicare & Medicaid Services

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