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      CLAIM ADJUSTMENT OR APPEAL REQUEST FORM. NOTE: Appeals related to a claim denial for lack of prior authorization must be received within 60 days of the denial date.All other adjustments and appeals must be received within 12 months of the original denial date.. One form per claim. FOR MEMBERS WITH GROUP/POLICY:


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    • [DOC File]Diagnosis-Related Groups (DRG): Inpatient Services ...

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      Introduction Beginning in July 2013, payment for inpatient general acute care for many hospitals is calculated using an all patient refined diagnosis related groups (APR-DRG) model.DRG is a system that uses information on the claim (including revenue, diagnosis and procedure codes, patient’s age, discharge status and complications) to classify the hospital stay into an APR-DRG group.



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      OPIOID START TALKING (MUST BE INCLUDED IN THE PATIENT’S MEDICAL RECORD) Michigan Department of Health and Human Services Patient Name Date of Birth


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