Aetna Definition Of Medically Necessary

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Health Care & Insurance Glossary of Terms | Aetna

https://www.aetna.com/glossary.html

Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Your benefits plan determines coverage. Some plans exclude …

Medical Necessity Definition in Health Insurance

https://www.verywellhealth.com/medical-necessity-1738748

Medical necessity refers to a decision by your health plan that your treatment, test, or procedure is necessary to maintain or restore your health or to …

Applied Behavior Analysis (ABA) Medical Necessity …

https://www.aetna.com/health-care-professionals/newsletters-news/office-link-updates-june-2021/behavioral-health-updates/applied-behavior-analysis-aba-medical-necessity-guide-revised-edition.html

Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be …

Difficulties of Defining Medical Necessity, Health Law

https://www.law.uh.edu/healthlaw/perspectives/Managed/001129Difficulties.html

In the settlement agreement, Aetna agreed that medically necessary care was to be defined as "health services and supplies that under the applicable standard of care are …

Medical Necessity: Is It Really Necessary

https://www.aapc.com/blog/77660-medical-necessity-is-it-really-necessary/

Aetna has a policy with a list of acceptable diagnoses for hyperbaric oxygen therapy (HBOT), if criteria are met. The policy identifies medically necessary …

Skilled Home Private Duty Nursing Care - Medical …

https://www.aetna.com/cpb/medical/data/100_199/0136.html

One day of medically fragile daycare is considered equivalent to 8 hours of private duty nursing. If the member who is participating in such a program can not attend medically …

Medically necessary - Glossary | HealthCare.gov

https://www.healthcare.gov/glossary/medically-necessary/

Medically necessary Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of …

What Does 'Medically Necessary' Mean? - Medicare.org

https://www.medicare.org/articles/what-does-medically-necessary-mean/

According to CMS, medically necessary services or supplies: Are proper and needed for the diagnosis or treatment of your medical condition. Are provided for the diagnosis, …

Infertility - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/300_399/0327.html

As defined in Aetna commercial policies, health care services are not medically necessary when they are more costly than alternative services that are at least as likely to produce …

Safety Items - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/600_699/0623.html

Under non-standard plans that do not exclude safety items, continuously worn prefabricated or custom-made soft or hard specialized medical protective helmets …

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