MYTHBUSTER: Who has the authority to establish medical necessity?
September 1, 2022 8:00 amMyth: Any physician is allowed to determine if medical criteria was met to establish medical necessity. Fact: A physician or appropriate... View more
Categories for Industry Updates
Obtaining Authorization While Patient Is In House
June 29, 2022 8:44 amA large 11 hospital provider member recently submitted a complaint to ERN/TRAF against a health plan who failed to approve... View more