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An Elderly Female Client Was Receiving Home Care After Hospitalization

Question 9

Multiple Choice

An elderly female client was receiving home care after hospitalization for a cerebrovascular accident. After several weeks of physical and speech therapy, the client showed few signs of progress. The utilization review committee considered the client's condition to be stable and declined reimbursement for further home care. This client may reverse the decision through a process called:


A) Development of explicit criteria
B) Appeal mechanism
C) Concurrent utilization review
D) Medicare reversal process

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