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Spotlight Mandate: Member appeal process

Worried disabled self employed working at home

Members will have the option for an external review if they believe their claim for a No Surprises Act item or service was handled improperly.

Who it applies to: All members of fully insured group health plans, self-funded group health plans and individual policies – including all grandfathered plans.

Effective date: Plan years beginning on or after Jan. 1, 2022

Action required: No member or employer group action is required at this time. BCBSND will update its member appeal process to comply.