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
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.