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DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Medicaid Services Wis. Stats. 46.287(2)(c) F00237 (09/2017) appeal request CARE WISCONSIN Completion of this form is voluntary. The personally
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An appeal request in Care Wisconsin is a formal request made by a member or provider to challenge a decision made by the managed care organization.
Any member or provider who disagrees with a decision made by Care Wisconsin is required to file an appeal request.
To fill out an appeal request in Care Wisconsin, one must follow the instructions provided by the managed care organization and provide all relevant information and supporting documentation.
The purpose of an appeal request in Care Wisconsin is to provide a mechanism for members and providers to challenge decisions made by the managed care organization.
The appeal request in Care Wisconsin must include information such as the member's name, identification number, reason for the appeal, and any supporting documentation.
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