Time period may be extended 15 days if for reasons beyond control of administrator. If extension is needed because of lack of information submitted with claim, claimant gets 45 days to provide information. Post-service claims . Notice of adverse benefit determination within 30 days, subject to 15-day extension. Calculating time periods .
Time period begins when claim is filed without regard to whether information is complete.
If period is extended because of incomplete information, time period is tolled when notice of extension is sent. Manner and content of notice of initial benefit determination. For all plans, the plan administrator shall provide written or electronic notice of adverse benefit determinations. Urgent care . Appeal adverse benefit determination.