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Glossary of Terms | Health Insurance, Medicare & More

    https://www.anthem.com/glossary/
    Medically necessary/medical necessity Health care services or supplies that are a reasonable part of your care. Sometimes we’ll ask your doctor to show that the care …

An overview of our medical necessity review process

    https://providernews.anthem.com/california/article/an-overview-of-our-medical-necessity-review-process-1
    If you are the treating practitioner directly involved in the member’s care/treatment plan and need to discuss a medical necessity review decision, an …

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 …

CG-DME-10 Durable Medical Equipment - Anthem

    https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053621.html
    This document defines general principles used to determine the medical necessity of durable medical equipment (DME) and includes a general definition of …

CG-MED-23 Home Health - Anthem

    https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053760.html
    Certain extended home infusion treatments are considered medically necessary because they are more appropriately performed in the home setting, even if …

What Does Medically Necessary Mean in Medicare?

    https://www.ehealthinsurance.com/medicare/coverage/medically-necessary-definition/
    Medicare’s definition of “medically necessary” According to Medicare.gov, health-care services or supplies are “medically necessary” if they: Are needed to …

CG-MED-21 Anesthesia Services and Moderate …

    https://www.anthem.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_a050123.html
    For surgical procedures which do not usually require anesthesia services, anesthesia services including monitored anesthesia care (MAC) are …

What Does 'Medically Necessary' Mean? - Medicare.org

    https://www.medicare.org/articles/what-does-medically-necessary-mean/
    If you are a Medicare beneficiary, you may have come across the term, “medically necessary” to refer to services covered by Medicare. But what does it mean? According …

Medical Necessity and the Effect on …

    https://www.thebalancemoney.com/what-s-medical-necessity-how-does-it-affect-insurance-4172148
    An ambulance is considered medically necessary when all other methods of transportation are unacceptable. If all other transportation options would …



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