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Alaska Administrative Code (Last Updated: January 12, 2017) |
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Title 2. Administration. |
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Chapter 2.39. Group Health and Life Insurance. |
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Article 2.39.5. Appeals From Denials of Medical Claims Under the Medical Coverage Provided by the Teachers' Retirement System. |
Section 2.39.640. Emergency procedures.
Latest version.
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(a) The plan administrator and the board may review claims of an emergency nature on an expedited basis, including use of shortened schedules, telephonic proceedings, and other procedures necessary to facilitate prompt determinations. "Emergency" as used in this section is limited to determinations where a patient's life or health would be threatened by delay, and substantial deference shall be afforded to a certificate by an enrollee's treating physician that such an emergency exists. (b) Appeals granted under emergency procedures do not have any precedential value in future appeals due to the abbreviated nature of emergency procedures, and any medical treatment approved in an emergency procedure is not thereby approved for any claimant not specifically a party to emergency procedure.
Authorities
14.25.035;14.25.168