Aetna Definition Medically Necessary

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Medical Clinical Policy Bulletins - Aetna

https://www.aetna.com/health-care-professionals/clinical-policy-bulletins/medical-clinical-policy-bulletins.html

Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Your benefits plan determines coverage. Some plans exclude coverage for …

Health Care & Insurance Glossary of Terms | Aetna

https://www.aetna.com/glossary.html

Earnings definition. This is the base pay for calculating disability benefits. The benefits could be short- or long-term. ... Some plans exclude coverage for services or supplies …

Precertification – Health Care Professionals | Aetna

https://www.aetna.com/health-care-professionals/precertification.html

Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be …

Medical Necessity Definition in Health Insurance

https://www.verywellhealth.com/medical-necessity-1738748

Medical necessity refers to a decision by your health plan that your treatment, test, or procedure is necessary to maintain or restore your health or to treat a …

Medical Necessity: Is It Really Necessary

https://www.aapc.com/blog/77660-medical-necessity-is-it-really-necessary/

“Medical necessity” is an important concept for medical coders and auditors to Understanding a payer’s definition of medical necessity is essential to getting …

Medically necessary - Glossary | HealthCare.gov

https://www.healthcare.gov/glossary/medically-necessary/

Review the definition of medically necessary in the HealthCare.gov Glossary. ... Medically necessary. Health care services or supplies needed to diagnose or treat an …

Skilled Home Health Care Nursing Services - Medical …

http://www.aetna.com/cpb/medical/data/200_299/0201.html

Subject to applicable benefit plan terms and limitations, Aetna considers skilled home health nursing services medically necessary when all of the following criteria are …

Physical Therapy - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/300_399/0325.html

Number: 0325. Policy. Aetna considers physical therapy (PT) medically necessary when this care is prescribed by a chiropractor, DO, MD, nurse practitioner, podiatrist or other …

“Medically Necessary” Defined - AgingInPlace.org

https://aginginplace.org/finance-legal/medically-necessary-defined/

According to the Medicare glossary, medically necessary refers to: Health care services or supplies needed to diagnose or treat an illness, injury, condition, …

Difficulties of Defining Medical Necessity, Health Law

https://www.law.uh.edu/healthlaw/perspectives/Managed/001129Difficulties.html

The definition of the term medical necessity varies depending upon whether the term is being used by providers, physicians, courts, ... Aetna agreed that medically necessary …

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