Notice of Adverse Benefit Determination

Name Description Type Action
SLOBHD-NOABD-Attachments NOABD Attachments File Download
SLOBHD-NOABD-Authorization-Delay Authorization Delay NOABD File Download
SLOBHD-NOABD-Denial Denial NOABD File Download
SLOBHD-NOABD-Financial-Liability Financial Liability NOABD File Download
SLOBHD-NOABD-Grievance-Appeal-Delay Grievance or Appeal Delay NOABD File Download
SLOBHD-NOABD-Modification Modification NOABD File Download
SLOBHD-NOABD-Other-LOC Other Level of Care NOABD File Download
SLOBHD-NOABD-Payment-Denial Payment Denial NOABD File Download
SLOBHD-NOABD-Termination Termination NOABD File Download
SLOBHD-NOABD-Timely-Access SLOBHD-NOABD-Timely-Access File Download

Please contact our access line at 1 (800) 838-1381 for information or to schedule an appointment. All services are available in Spanish.