Hometown Health Administrative Guidelines | Page 70

non-participating providers that were not involved in the initial denial decision . At least one practitioner must be a participating provider who is not otherwise involved in network management and who is a clinical peer of the participating provider that filed the dispute . The clinical peer will have the same licensure as the appellant .
3 . The appellant will be notified of the date and time of the meeting so he / she can call in and / or provide additional information . Any additional information supplied by the appellant must be received no later than two weeks before the scheduled appeal meeting in order to be considered at the meeting .
4 . If the MAC meeting is two weeks away or less on the date of the notification , the appellant will be given the option to postpone the appeal until the next scheduled MAC meeting or the Committee may postpone the appeal until the next scheduled MAC meeting .
The appeal will be considered informal , with the MAC minutes documenting the attendees , the highlights of the discussion , and the decision of the Committee . Attorneys are not invited to participate on behalf of the appellant at a level 1 appeal .
5 . Any data the appellant supplies must be :
• Detailed ;
• Documented in writing by the appellant and / or include copies of documents such as a license , DEA certificate , letters of support , etc . and
• Verifiable , either orally , written or through Internet website data , through acceptable sources identified in Hometown Health ’ s Standards for Participation policy & procedure .
• The Committee will notify the practitioner in writing of its decision within t e n ( 10 ) business days of the meeting . The written notification will contain an explanation of the reason ( s ) for the MAC ' s ' decision and the practitioner ' s right to appeal at the Level II stage .
• The practitioner has thirty ( 30 ) days from receipt of the notification to request a Level II appeal .
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• If the provider does not request a Level II Appeal within 30 days , the provider ’ s