Burden Estimates - Appeals

Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered Group Health Plans and Issuers and Individual Market Issuers (CMS-10338)

OMB: 0938-1099

IC ID: 193861

Documents and Forms
Document Name
Document Type
Other-Model - Notice
Other-Model - Notice
Other-Model - Notice
Other-Model - Notice
Other-Model Notice
Other-Model Notice
Information Collection (IC) Details

View Information Collection (IC)

Burden Estimates - Appeals
 
No Unchanged
 
Mandatory
 
45 CFR 147.136

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Model - Notice CMS-10338_Instrument_1_Adverse_Benefit_Determination_model_notice_508.pdf Yes Yes Fillable Fileable
Other-Model - Notice CMS-10338_Instrument_2_Final_Internal_Adverse_Benefit_Determination_model_notice_508.pdf Yes Yes Fillable Fileable
Other-Model Notice CMS-10338_Instrument_3_Final_External_Review_Decision_model_notice_508.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

109,653 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 516,575,283 0 0 0 516,575,283 0
Annual IC Time Burden (Hours) 1,195,626 0 0 0 1,195,626 0
Annual IC Cost Burden (Dollars) 149,806,832 0 0 0 149,806,832 0

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