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Managed Care Nursing

Category - Overview

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What is the term for a physician or member submitting a written disagreement regarding a decision to deny or limit coverage, care, or service by the MCO?

Denial
Grievance
Approval
Authorization
Appeal

Explanation

Answer: E - Appeal is the term used when a physician or member submits a written disagreement regarding a decision to deny or limit coverage, care or service by the MCO.

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