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2. Medical necessity - Wikipedia

   en.wikipedia.org/wiki/Medical_necessity

   Medicare pays for medical items and services that are "reasonable and necessary" or "appropriate" for a variety of purposes. [1] By statute, Medicare may pay only for items and services that are "reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member" unless there is another statutory authorization for payment.

3. Certificate of medical necessity - Wikipedia

   en.wikipedia.org/wiki/Certificate_of_medical...

   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.

4. Utilization management - Wikipedia

   en.wikipedia.org/wiki/Utilization_management

   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 ...

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6. Medical billing - Wikipedia

   en.wikipedia.org/wiki/Medical_billing

   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]

7. Medical guideline - Wikipedia

   en.wikipedia.org/wiki/Medical_guideline

   Plates vi & vii of the Edwin Smith Papyrus (around the 17th century BC), among the earliest medical guidelines. A medical guideline (also called a clinical guideline, standard treatment guideline, or clinical practice guideline) is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare.

8. Medical certificate - Wikipedia

   en.wikipedia.org/wiki/Medical_certificate

   A medical certificate can also be obtained online through telemedicine platforms, such as MedBond, which offer authentic medical certificates. An aegrotat ( / ˈ iː ɡ r oʊ t æ t / ; from Latin aegrotat 'he/she is ill') [ 5 ] or 'sick note' is a type of medical certificate excusing a student's absence from school for reasons of illness .

9. Medical prescription - Wikipedia

   en.wikipedia.org/wiki/Medical_prescription

   In the countries of the UK, National Health Service (NHS) prescriptions are either free or have a fixed price per item; [43] a prescription may be issued so the patient does not have to purchase the item at commercial price. Some medical software requires a prescription. [44] Legislation may define certain equipment as "prescription devices". [45]