Question
CMS and others, such as some BCBS carriers, undergo a rigorous process to determine whether services are appropriate for reimbursement based on a definition of
CMS and others, such as some BCBS carriers, undergo a rigorous process to determine whether services are appropriate for reimbursement based on a definition of the medical necessity of services. Highmark BCBS has reasoned that a service must meet five criteria to be paid. Discuss those criteria? Include in your discussion if you think they are reasonable or unreasonable and why?
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ANSWER Yes lthugh sme urts hve held tht the sle resnsibility fr determining medil neessity shuld be ...
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Financial Accounting
Authors: J. David Spiceland, Wayne Thomas, Don Herrmann
3rd edition
9780077506902, 78025540, 77506901, 978-0078025549
