6.7 REQUEST FOR REVIEW OF A DENIAL OF BENEFITS BASED ON CONCURRENT REVIEW

If the Utilization Management Organization determines continued services are not Medically Necessary, you and/or your Physician will be notified and you will have the opportunity to request review of the determination. The obligation to request review rests entirely with you. The review procedures for concurrent review are the same as those for precertification review; see Section 6.5.