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Site Contents

HEALTH PLAN'S APPEALS PROCEDURE

If you disagree with our decision not to pay or arrange for health services or supplies that you have received or requested, you have the right to request an appeal of our decision. Your written request for reconsideration must be filed within 60 days from the date of our initial determination. You will receive a written response from us within 60 days of the receipt of your appeal.

Health Plan's appeals procedure applies to claims for Out-of-Plan Emergency or Urgent Care Services and to situations in which we have failed to provide or pay for a covered service to which you believe you are entitled. For all other claims, binding arbitration is the last resort for any dispute or claim you cannot resolve through Health Plan's procedures. See page 11 for information on binding arbitration.

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NAVIGATION

Introduction | Benefit Changes | How to Use | Definitions | How Your Plan Works | Who Is Eligible | When Coverage Starts | Benefits And Services | Referrals and Restrictions on Choice of Providers | Emergency Services | Urgent Care | Health Plan's Appeals Procedure | Special Claims Procedures for Medicare Members | General Provisions | Binding Arbitration | Coordination Of currentbenefits | Medicare | What Is Not Covered | When Coverage Stops | Continuation Of Coverage | Customer Satisfaction Procedure | Service Information | Statement Of Financial Condition | Important Phone Numbers | Local Designated Hospitals | Supplemental Benefits | Benefit Chart


Website for Kaiser of Colorado


Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371