Q: We are trying to educate our coding department about medical necessity, but has CMS or Medicare defined it anywhere? How can we explain it to staff?
Q: Does a hospital need to obtain the patient's written consent before obtaining physician office notes? Can I contact the physician office and request the needed information without obtaining a written consent from the patient? The office notes are needed for payment purposes.
Q: Our facility does not have a standard appeal letter template to respond to medical necessity denials. Do you have any suggestions for how to respond?
