98 the Plan’s control. In that case, you will be notified of the extension before the end of the initial 15- or 30-calendar day period. The time period may be extended because you have not submitted sufficient information, in which case you will be notified of the specific information necessary and given an additional period of at least 45 calendar days after receiving the notice to furnish that information. You will be notified of the Plan’s claim decision no later than 15 calendar days after the end of that additional period (or after receipt of the information, if earlier). For pre-service claims which name a specific claimant, medical condition and service or supply for which approval is requested, and which are submitted to a Plan representative responsible for handling benefit matters, but which otherwise fail to follow the Plan’s procedures for filing pre-service claims, you will be notified of the failure within five calendar days (within 24 hours in the case of an urgent care claim) and of the proper procedures to be followed. The notice may be oral unless you request written notification. Note: Any claim CareFirst Administrators receives more than one year after the expense is incurred will be denied as untimely. CareFirst Administrators may also have shorter filing limits for some network providers. You will not be responsible for payment of charges CareFirst Administrators denies for untimely filing if a CareFirst Administrators contracted provider fails to file your claim in accordance with CareFirst Administrator’s contractual requirements. Ongoing Course of Treatment If you have received precertification for an ongoing course of treatment, you will be notified in advance if the Plan intends to terminate or reduce benefits for the previously authorized course of treatment so that you will have an opportunity to appeal the decision and receive a decision on that appeal before the termination or reduction takes effect. If the course of treatment involves urgent care, and you request an extension of the course of treatment at least 24 hours before its expiration, you will be notified of the decision within 24 hours after receipt of the request. Notice of Decision If your claim is denied, you will be provided with written notice of denial of the claim (whether denied, in whole or in part). This notice generally will be provided by CareFirst Administrators, except in some cases, by the Fund Office on behalf of the Trustees. For example, if the decision relates to Plan eligibility. This notice will state: • The claim involved. • The specific reason(s) for the determination. • The Plan standard that was used, if any. • The specific Plan provision(s) on which the determination is based. • A description of any additional material or information necessary to perfect or decide the claim, and an explanation of why the material or information is necessary. • A description of the appeal procedures (including the external appeal opportunity) and applicable time limits for pursuing the appeal or filing a legal claim.