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Delaware Petition to Appeal a Utilization Review

Category:
Delaware Workers Compensation - Official
State:
Delaware
Control #:
DE-014-WC
Format:
PDF
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Description

Petition to Appeal a Utilization Review A Delaware Petition to Appeal a Utilization Review is a process that allows individuals to challenge a Utilization Review decision made by their insurance company. This process is regulated by the Delaware Insurance Department and involves filing a formal petition with the department. The petition must include a statement of facts, the reasons why the petitioner believes the Utilization Review decision is incorrect, and any additional evidence and information. Once the petition is received, the department will review the case and make a decision. The two types of Delaware Petition to Appeal a Utilization Review are: 1. Pre-Service Utilization Review Appeal: This type of appeal is used when a Utilization Review decision is made prior to a medical service being provided. 2. Post-Service Utilization Review Appeal: This type of appeal is used when a Utilization Review decision is made after a medical service has been provided.

A Delaware Petition to Appeal a Utilization Review is a process that allows individuals to challenge a Utilization Review decision made by their insurance company. This process is regulated by the Delaware Insurance Department and involves filing a formal petition with the department. The petition must include a statement of facts, the reasons why the petitioner believes the Utilization Review decision is incorrect, and any additional evidence and information. Once the petition is received, the department will review the case and make a decision. The two types of Delaware Petition to Appeal a Utilization Review are: 1. Pre-Service Utilization Review Appeal: This type of appeal is used when a Utilization Review decision is made prior to a medical service being provided. 2. Post-Service Utilization Review Appeal: This type of appeal is used when a Utilization Review decision is made after a medical service has been provided.

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