Medical Necessity in Medical Billing
Medical necessity refers to healthcare services or treatments that are deemed essential and appropriate for the diagnosis or treatment of a medical condition.
Medical Necessity in Medical Billing Explained
In medical billing, insurance companies require proof that services provided are medically necessary before approving claims for payment. Providers must document the patient’s condition and the treatment required to justify the necessity of the service.
For example, a doctor submits documentation to an insurance company showing that an MRI is medically necessary to diagnose a patient’s condition.
See common acronyms and abbreviations in Medical billing glossary.
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