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Burden Estimates - Appeals
 
No Modified
 
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 of Internal Adverse Benefit Determination Yes Yes Fillable Fileable
Other-Model Notice of Adverse Benefit Determination Yes Yes Fillable Fileable
Other-Model Notice of Final External Review Decision Yes Yes Fillable Fileable

Health Health Care Services

 

91,530 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   58 %

  Requested 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 489,975,255 0 0 -26,600,028 516,575,283 0
Annual IC Time Burden (Hours) 861,470 0 0 -334,156 1,195,626 0
Annual IC Cost Burden (Dollars) 142,092,824 0 0 -7,714,008 149,806,832 0

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