Standard for Full and Fair Review for Urgent Care

In the case of a claim involving urgent care, the plan must provide an expedited review process, pursuant to which –

1. A request for an expedited appeal of an adverse benefit determination may be submitted orally or in writing by the claimant; and
2. All necessary information, including the plan’s benefit determination on review, must be transmitted between the plan and the claimant by telephone, facsimile, or other available similarly expeditious method.