Part 10 – Appeal and Grievance Program (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 93 of the review agency. This notice will also state whether or not your case is being reviewed on an expedited basis. This notice will also be sent to Blue Cross Blue Shield HMO Blue along with a copy of your signed medical information release form. External Review Decisions and Notice The review agency will consider all aspects of the case and send a written response of the outcome. They will send the response to you (or your authorized or legal representative) and to Blue Cross Blue Shield HMO Blue within 45 calendar days of receiving the referral from the Office of Patient Protection. In the case of an expedited review, you will be notified of their decision within 72 hours. This 72-hour period starts when the review agency receives your case from the Office of Patient Protection. If the review agency overturns Blue Cross Blue Shield HMO Blue’s decision in whole or in part, Blue Cross Blue Shield HMO Blue will send you (or your authorized or legal representative) a notice within five working days of receiving the review decision made by the agency. This notice will confirm the decision of the review agency. It will also tell you: what steps or procedures you must take (if any) to obtain the requested coverage or services; the date by which Blue Cross Blue Shield HMO Blue will pay for or authorize the requested services; and the name and phone number of the person at Blue Cross Blue Shield HMO Blue who will make sure your appeal or grievance is resolved. The decision made by way of the external review process will be accepted as final. You have the right to look at and get copies of records and criteria that Blue Cross Blue Shield HMO Blue has and that are relevant to your appeal or grievance. These copies will be free of charge.