If you appeal, you or your authorized representative may, upon request and free of charge, have reasonable access to all documents relevant to your claim appeal. Relevant documents include documents relied on, submitted, considered or generated in making the benefit determination, including any internal guidelines or policies considered in processing your appeal. If the denial is based on a medical determination, an explanation of that determination, and its application to your medical situation, is also available upon request.

If you are not satisfied with the decision of the Internal Grievance or Appeal and your Appeal involves an Adverse Benefit Determination, you may request a voluntary second level internal appeal. If your case is eligible, it will be reviewed by the claims appeal panel.