Forum - Questions & Answers

Aug 2nd, 2011 - Antony1

Medical necessity denial

How to resolve a medical necessity denial??

Aug 2nd, 2011 -

re: Medical necessity denial

details please. They are saying the test was not medically necessary. Usu the doc has to prove it was by writing a letter

Aug 2nd, 2011 - DebraS   67 

re: Medical necessity denial

Limited information. Does the documentation/dx match the carrier's policy for the treatment/services provided and does the documentation match? Is it a not covered benefit. Look up their policy. Would need cpt/icd-9 as starters. I would first look at their policy on it and go from there.



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