Medically Necessary For Medical Schools

Decent Essays

Medically Necessary is used by most doctors and health insurance companies to describe medical services like, treatments, drugs, and tests from the doctors. Medically necessary includes the following four parts: “1. Most doctors agree that the treatment is useful and helps people. They use the treatment for their patients. The treatment is taught in medical schools. Doctors recognized as experts by other doctors recommend the service. 2. Most doctors say this is the right or best treatment for a specific disease or problem. Medical schools and experts agree that this is a good treatment for the problem. 3. The service is not just for the convenience of the doctor, the patient or the family. 4. The service does not cost far more than a treatment that is just as likely to work for the problem.” Now medically necessary does not mean that a recommended treatment was made by the doctor. Remember all health insurers us this term and that the specific meaning is listed in all benefit books. To use the medically necessary treatments you have to meet all of the points listed above or the plan will not be covered by medical ( Code Linkage To establish medical necessity, diagnosis codes have to be correctly linked to procedures. What is provided to a patients by the health care worker and or doctor’s needs to have medical codes assigned to them. This way billing can be attached correctly. An example would be if you cut your hand with a knife

Get Access