Notice of denial of payment
Notice of denial of payment means, with respect to an item or service for which benefits subject to the protections of 54.98164T, 54.98165T, and 54.98171T are provided or covered, a written notice from the plan to the health care provider, facility, or provider of air ambulance services, as applicable, that payment for such item or service will not be made by the plan and which explains the reason for denial. The term notice of denial of payment does not include a notice of benefit denial due to an adverse benefit determination as defined in 29 CFR 2560.5031.