Question: Complex Escalation 1: A client has requested a dependent review process for a member that is aging out of a specialty plan (their dental carrier),

Complex Escalation 1:

A client has requested a dependent review process for a member that is aging out of a specialty plan (their dental carrier), which does not match the overage dependent age of 26 that XYZA COMPANY facilities. XYZA COMPANY does not complete a medical review for disability until 90 days prior to the members 26^th birthday. You have already responded to explain our standard, but the client is insistent that we help since their dental vendor doesnt have the ability to perform this review.

How would you proceed internally?

What message would you send the client?

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