What Do I Do If My Claim Is Denied? Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 59 • Concurrent Care Requests: A request to extend an already approved ongoing course of treatment that was approved for a specific period of time or a specific number of treatments. If the request is urgent, we will follow the urgent care request for Benefits and appeals process. If it is not urgent, it will be treated like a new request for services and will follow the Pre-Service Request for Benefits and Appeal process. • Pre-Service Request for Benefits: A request for Benefits which the Surest Plan must approve or for which you must notify Surest before non-urgent care is provided. • Post-Service Medical Claim Request for Benefits: A medical Claim for reimbursement of the cost of non-urgent care that has already been provided. Please note that the decision is based only on whether or not Benefits are available under the Surest Plan for the proposed treatment or procedure. You may have the right to external review through an Independent Review Organization (IRO) upon completion of the internal appeal process. Instructions regarding any such rights, and how to access those rights, will be provided in a decision letter to you from Surest. The tables below describe the time frames which you and Surest are required to follow. Urgent Care Request for Medical Benefits and Appeal* Request for Urgent Care or Concurrent Care Benefits Claims Timing If your request for medical Benefits is incomplete, Surest must notify you within: 24 hours and advise you what information is needed You must then provide a completed request for medical Benefits to Surest within: 48 hours after receiving notice of additional information required Surest must notify you of the medical Benefit determination within: 48 hours of receiving the needed information If your request for medical Benefits is complete when it is filed, Surest must notify you within: 72 hours If Surest denies your request for medical Benefits, you must appeal an Adverse Benefit Determination no later than: 180 days after receiving the Adverse Benefit Determination Expedited Appeals (Urgent Care or Concurrent Care) Appeals Timing Surest must notify you of the medical Claim appeal decision within: 72 hours after receiving the medical Claim appeal — if the medical Claim appeal is still urgent. If services have already been provided, we follow the post-service medical Claim appeals process. *Follow the procedure for an Expedited Appeal provided in your denial of coverage letter.