Most health plan contracts provide an outline of the criteria that a healthcare service must meet in order to be conside
Posted: Fri May 05, 2023 11:03 am
Most health plan contracts provide an outline of the criteria that a healthcare service must meet in order to be considered "medically necessary." Typically, in order for a healthcare service to be considered medically necessary, the service provided by a physician or other healthcare provider to identify and treat a member's illness or injury must be:
A. Consistent with the symptoms of diagnosis
B. Furnished in the least intensive type of medical care setting required by the member's condition
C. In compliance with the standards of good medical practice
D. All of the above
A. Consistent with the symptoms of diagnosis
B. Furnished in the least intensive type of medical care setting required by the member's condition
C. In compliance with the standards of good medical practice
D. All of the above