Which statement differentiates grievance from an appeal in health insurance?

Which statement differentiates grievance from an appeal in health insurance?

• A. A grievance is a complaint about services or care; an appeal challenges a coverage decision on whether a service should be provided or paid.
• B. The terms have opposite meanings: a grievance is about coverage decisions, and an appeal is about services or care.
• C. Grievance and appeal refer to the same process.
• D. Grievance pertains to provider licensure; appeal pertains to facility accreditation.

Answer: (B)