What Do I Do If My Claim Is Denied? Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 60 Pre-Service Request for Medical Benefits and Appeal* Request for Pre-Service Benefits Claims Timing If your request for medical Benefits is filed improperly, Surest must notify you within: 5 days If your request for medical Benefits is incomplete, Surest must notify you within: 15 days You must then provide a completed request for medical Benefits information to Surest within: 45 days Surest must notify you of the medical Benefit determination: • If the initial request for medical Benefits is complete, within: 15 days • After receiving the completed request for medical Benefits (if the initial request for medical Benefits is incomplete), within: 15 days* *Surest may require a one-time extension for the request for Pre-Service Benefits, of no more than 15 days only if more time is needed due to circumstances beyond control of the Surest Plan. Surest will notify you if Surest determines that the additional time is needed before the 15 days expires. You must appeal an Adverse Benefit Determination no later than: 180 days after receiving the Adverse Benefit Determination Appeals (Pre-Service) Appeals Timing Surest must notify you of the first-level medical Claim appeal decision within: 15 days after receiving a complete first-level medical Claim appeal You must appeal the first-level medical Claim appeal (file a second-level medical Claim appeal) within: 60 days after receiving the first- level medical Claim appeal decision Surest must notify you of the second-level medical Claim appeal decision within: 15 days after receiving a complete second-level medical Claim appeal Post-Service Medical Claim Request for Benefits and Appeal* Post-Service Claim Claims Timing If your medical Claim is incomplete, Surest must notify you within: 30 days You must then provide completed medical Claim information to Surest within: 45 days Surest must notify you of the Benefit determination: • If the initial medical Claim is complete, within: 30 days • After receiving the completed medical Claim (if the initial medical Claim is incomplete), within: 30 days *Surest may require a one-time extension for the initial Post-Service Claim determination, of no more than 15 days only if more time is needed due to circumstances beyond control of the Surest Plan. Surest will notify you if Surest determines that the additional time is needed before the 30 days expires. You must appeal an Adverse Benefit Determination no later than: 180 days after receiving the Adverse Benefit Determination