Grier Template Notice

  • MCC 1 Word icon to symbol the link is a Word Document Denial of New Non-Covered Service before appeal
  • MCC 1a Word icon to symbol the link is a Word Document Denial of New Non-Covered Service before appeal - amount not specified
  • MCC 1p Word icon to symbol the link is a Word Document (Denial of New Non-Covered Service before appeal - prescriber not specified
  • MCC 1pa Word icon to symbol the link is a Word Document Denial of New Non-Covered Service before appeal - prescriber amount not identified
  • MCC 2 Word icon to symbol the link is a Word Document Initial Denial of New Non-Covered Service upon reconsideration
  • MCC 2a Word icon to symbol the link is a Word Document Initial Denial of New Non-Covered Svc upon reconsideration - amount not specified
  • MCC 2p Word icon to symbol the link is a Word Document (Initial Denial of New Non-Covered Svc upon reconsideration - prescriber not specified
  • MCC 2pa Word icon to symbol the link is a Word Document Initial Denial of New Non-Covered Svc upon reconsideration -prescriber amount not specified
  • MCC 3 Word icon to symbol the link is a Word Document Termination of Non-Covered Service
  • MCC 6 Word icon to symbol the link is a Word Document Medical Necessity Denial of New Service before appeal
  • MCC 6a Word icon to symbol the link is a Word Document Medical Necessity Denial of New Service before appeal - amount not specified
  • MCC 7 Word icon to symbol the link is a Word Document Initial Medical Necessity Denial of New Service upon reconsideration
  • MCC 7a Word icon to symbol the link is a Word Document Initial Medical Necessity Denial of New Svc upon reconsideratio-amount not specified
  • MCC 8 Word icon to symbol the link is a Word Document Reduction of Service based on Medical Necessity
  • MCC 9 Word icon to symbol the link is a Word Document Termination of Service based on Medical Necessity
  • MCC 10-11w Word icon to symbol the link is a Word Document Waiver of Right to Stay 2-Bs.Days aFTER notice of Provider-Initiated Termination
  • MCC 10 Word icon to symbol the link is a Word Document 2 business day advance notice of MCC-Initiated Hospital Discharge doc
  • MCC 11pr Word icon to symbol the link is a Word Document Post Reduction Notice of Provider-Initiated Reduction of BHO service for SPMI/SED, I/P psych, residential, or home health service, or service to treat a chronic condition across a continuum when next appropriate level of service not available
  • MCC 11pt Word icon to symbol the link is a Word Document Post Termination Notice of Provider-Initiated Termination of BHO service for SPMI/SED, I/P psych, residential, or home health service, or service to treat a chronic condition across a continuum when next appropriate level of service not available
  • MCC 11r Word icon to symbol the link is a Word Document 2-Bs Day Notice of Provider-Initiated Reduction of BHO service for SPMI/SED, I/P psych, residential, or home health service, or service to treat a chronic condition across a continuum when next appropriate level of service not available
  • MCC 11rf Word icon to symbol the link is a Word Document 2-Bs Day Notice of Provider-Initiated Reduction of BHO service for SPMI/SED, I/P psych, residential, or home health service, or service to treat a chronic condition across a continuum when next appropriate level of service not available
  • MCC 11t Word icon to symbol the link is a Word Document 2-Bs Day Notice of Provider-Initiated Termination of BHO service for SPMI/SED, I/P psych, residential, or home health service, or service to treat a chronic condition across a continuum when next appropriate level of service not available
  • MCC 11tf Word icon to symbol the link is a Word Document 2-Bs Day Notice of Provider-Initiated Termination of BHO service for SPMI/SED, I/P psych, residential, or home health service, or service to treat a chronic condition across a continuum when next appropriate level of service not available
  • MCC 12 Word icon to symbol the link is a Word Document General Delay
  • MCC 12.net Word icon to symbol the link is a Word Document Network Shortage Delay
  • MCC 12.N-PCPterm Word icon to symbol the link is a Word Document Non-PCP Termination Delay
  • MCC 12.PCP Word icon to symbol the link is a Word Document PCP Change Delay
  • MCC 13 Word icon to symbol the link is a Word Document Prior authorization of Ongoing Service