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Map of US states that have Certificate-Of-Need laws. A certificate of need (CON), in the United States, is a legal document required in many states and some federal jurisdictions before proposed creations, acquisitions, or expansions of healthcare facilities are allowed.
A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]
Medical Necessity: Health Care Access and the Politics of Decision Making by Daniel Skinner, a book published by the University of Minnesota Press (2019). Charles Martin, "Medical Use of Cannabis in Australia: 'Medical necessity' defences under current Australian law and avenues for reform" (2014) 21(4) Journal of Law and Medicine 875.
Physician's News Digest article on Certificates of Medical Necessity; Statutory definition of a CMN at the SSA website; Medicare manual that provides exhaustive information about the practical use of CMNs, particularly section 5.3. This is the official source of information for contractors administering the Medicare system about the use of CMNs.
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Carolina Center for Behavioral Health Greer: 138 — — Carolina Pines Regional Medical Center: Hartsville: Darlington: 116: Level III: ScionHealth: Cherokee Medical Center [1] Gaffney: Cherokee: 125 [1] — SRHS [1] Formerly Novant Health Gaffney Medical Center and later Mary Black Health System - Gaffney [1] Coastal Carolina Hospital ...
COLUMBIA — The transfer portal rumors erupted quickly for South Carolina football after ending the 2023 season on a brutal 16-7 loss to Clemson.. The Gamecocks (5-7, 3-5 SEC) missed a bowl game ...
The Regional Medical Center of Orangeburg & Calhoun Counties (or TRMC for short) is a 286-bed non-profit hospital in Orangeburg, South Carolina. It is owned and operated jointly by the counties of Orangeburg and Calhoun , governed by a 17-member board representing both counties. [ 1 ]