South Carolina Code 38-71-1990. External review decisions final; exceptions
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(A) An external review decision is binding on the health carrier.
(B) An external review decision is binding on the covered person except to the extent the covered person has other remedies available under applicable federal or state law. If such other remedies are available, the covered person or his authorized representative may not, in these proceedings, utilize, disclose, or introduce in evidence information generated during or findings reached by the independent review organization.
Terms Used In South Carolina Code 38-71-1990
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Person: means a corporation, agency, partnership, association, voluntary organization, individual, or another entity, organization, or aggregation of individuals. See South Carolina Code 38-1-20
(C) A covered person or his authorized representative may not file a subsequent request for external review involving the same adverse determination or final adverse determination.