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Medicare Compliance & Reimbursement

Reader Questions:

Know These Facts on Addressing Part C Grievances

Published on Mon Jul 04, 2022

Question: One of the providers in our Medicare Advantage (MA) plan received a grievance. We are confused. Do we appeal that? Is it a denial? North Carolina Subscriber Answer: First, know that a grievance is not a claims denial. A Part C grievance refers to a beneficiary’s complaint. “A grievance is an expression of dissatisfaction (other than an organization determination) with any [...]
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