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Predetermination | definition of predetermination by …

    https://medical-dictionary.thefreedictionary.com/predetermination
    (111) The court, defining "predetermination" as occurring only when an agency "irreversibly and irretrievably commits itself to a plan of action that is dependent upon the NEPA environmental analysis producing a certain outcome," (112) makes it clear that …

Health Insurance Terms: What is a predetermination?

    https://connect.bcbstx.com/understanding-benefits/b/weblog/posts/health-insurance-terms-what-is-a-predetermination
    A predetermination of benefits is a review by your insurer’s medical staff. They decide if they agree that the treatment is right for your health needs. …

Understanding Predetermination - BCBSIL

    https://www.bcbsil.com/PDF/sprint_understanding_predetermination.pdf
    “Predetermination” is a review by Blue Cross and Blue Shield of Illinois (BCBSIL) of a doctor’s recommended medical procedure, treatment or test to make sure it meets …

Difference Between Predetermination and Prior Authorization

    https://www.outsourcestrategies.com/blog/predetermination-vs-prior-authorization/
    A predetermination is a formal review of a patient’s requested medical care compared to their insurance’s medical and reimbursement policies (MGMA). The aim is …

Recommended Clinical Review (Predetermination) | Blue Cross …

    https://www.bcbsil.com/provider/claims/claims-eligibility/utilization-management/predetermination
    A recommended clinical review (formerly called predetermination) is a medical necessity review conducted before services are provided. Submitting the request prior to rendering …

Predetermination Definition & Meaning - Merriam-Webster

    https://www.merriam-webster.com/dictionary/predetermination
    predetermination noun pre· de· ter· mi· na· tion ˌprē-di-ˌtər-mə-ˈnā-shən Synonyms of predetermination 1 : the act of predetermining : the state of being predetermined: such as …

Referral, predetermination, authorization, precertification: What's …

    https://www.mgma.com/resources/operations-management/guide-to-closing-a-private-equity-transaction-pre
    A predetermation is a formal review of a patient’s requested medical care compared to their insurances’ medical and reimbursement polices. The provider’s …

Insurance approvals: pre-certification and prior …

    https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/insurance-approvals
    Insurance approvals: pre-certification and prior authorizations. Your Mayo Clinic doctor will decide which procedures, tests and other consultations you may need. However, many …

Predetermine | definition of predetermine by Medical …

    https://medical-dictionary.thefreedictionary.com/predetermine
    pre·de·ter·mi·na·tion ( prē'dĕ-tĕr'mi-nā'shŭn) Determination of the reimbursement amount from a third-party payor before a health care service is performed. It does not guarantee …



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