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MODEL MTC/MMC EXTENSION NOTICE (Revised 11/17) FOR SERVICE AUTHORIZATION REQUESTS OR APPEALS Template begins below this line MCO/MTC OR DUAL LETTERHEAD FOR PLAN AND UR AGENT/BENEFIT MANAGER Plan Name
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What is new exhaustion requirement for?
The new exhaustion requirement is for tracking and reporting the utilization of benefits or resources.
Who is required to file new exhaustion requirement for?
All eligible entities or individuals are required to file the new exhaustion requirement.
How to fill out new exhaustion requirement for?
The new exhaustion requirement can be filled out online through the designated portal
What is the purpose of new exhaustion requirement for?
The purpose of the new exhaustion requirement is to ensure transparency and accountability in the utilization of benefits or resources.
What information must be reported on new exhaustion requirement for?
The new exhaustion requirement must include details of benefits or resources utilized, dates, and quantities.
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