[PDF][PDF] Medical necessity: making sense out of nonsense

HK Rabinowitz, K Hein - The Journal of the American Board …, 1997 - Am Board Family Med
Series Editor's Note: Medical necessity, a concept that is hard to define and frequently
misunderstood, has become critical to how health care is financed and delivered. Like most …

Medical necessity: do we need it?

LA Bergthold - Health Affairs, 1995 - healthaffairs.org
Prologue: For more than thirty years public and private health insurance plans have used
the term medical necessity as a placeholder to define the limits of their benefit coverage …

Prospects for improved decision making about medical necessity

SJ Singer, LA Bergthold - Health Affairs, 2001 - healthaffairs.org
With the backlash against managed care, medical necessity has become the focus of
increasing controversy. 1 California's health care marketplace has provided some unique …

[HTML][HTML] Medical necessity and evolving standards of care.

LM Sprague - Issue Brief (George Washington University. National …, 1999 - europepmc.org
The definition of “medically necessary,” a descriptive phrase employed in insurance
contracts to set boundaries on reimbursable services, has become a central topic in both …

Defining and implementing medical necessity in Washington State and Oregon

PD Jacobson, S Asch, PA Glassman, KE Model… - Inquiry, 1997 - JSTOR
This paper reports on a qualitative study of how health care providers in the states of
Washington and Oregon define and implement medical necessity. Based on a series of semi …

[PDF][PDF] Decreasing variation in medical necessity decision making

S Singer, L Bergthold, C Vorhaus, S Olson… - Final Report to the …, 1999 - chcf.org
Medical Necessity was not a problematic issue when remote third party payers rarely
challenged physicians' decisions and reimbursed physicians for whatever procedures they …

Defining medical necessity: Challenges and implications

G Griener - Health L. Rev., 2001 - HeinOnline
The concept of medically necessary services is deeply imbedded in the Canadian medicare
system, despite the fact that it seems to defy clear analysis. Coming to grips with this concept …

Who should determine when health care is medically necessary?

S Rosenbaum, DM Frankford, B Moore… - New England Journal …, 1999 - Mass Medical Soc
In the United States there has been a radical shift in the power to determine when health
care is medically necessary and therefore covered by insurance. From the 1950s through …

Redefining medical necessity: a consumer-driven solution to the US health care crisis

R Abbott, C Stevens - Loy. LAL Rev., 2013 - HeinOnline
The American health care system is plagued by high costs and poor public health outcomes,
due in part to the overuse of costly diagnostic tests and treatments. In 2009, the Institute of …

[BOOK][B] Medical Practice Management in the 21st Century: The Epidemiologically Based Needs Assessment Reviews, v. 2, First Series

M Satinsky, RT Curnow - 2017 - taylorfrancis.com
This title includes a Foreword by John W Bachman, Professor of Medicine, Mayo Clinic
College of Medicine, Rochester, Minnesota. Mastering the art of medical practice …