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Form Approved OMB No. 09380679 Expires 02/2020DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESCERTIFICATE OF MEDICAL NECESSITY CMS846 PNEUMATIC COMPRESSION DEVICES
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How to fill out certificate of medical necessity
How to fill out certificate of medical necessity
01
Gather all necessary information, such as patient's name, date of birth, medical history, and diagnosis.
02
Complete the sections on the form that require provider information, such as name, address, and qualifications.
03
Include details about the specific medical equipment or services being requested and the reasons why they are necessary for the patient's health and well-being.
04
Make sure to sign and date the form before submitting it to the appropriate party for review.
Who needs certificate of medical necessity?
01
Patients who require medical equipment or services that are deemed medically necessary by their healthcare provider.
02
Insurance companies or other third-party payers who require documentation of the medical necessity of a particular treatment or intervention.
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What is certificate of medical necessity?
The certificate of medical necessity is a document required by insurance companies to justify the need for certain medical services or equipment.
Who is required to file certificate of medical necessity?
Healthcare providers, physicians, or medical suppliers are required to file the certificate of medical necessity.
How to fill out certificate of medical necessity?
To fill out a certificate of medical necessity, one must provide detailed information about the patient's condition, the medical service or equipment needed, and the supporting medical documentation.
What is the purpose of certificate of medical necessity?
The purpose of the certificate of medical necessity is to ensure that the medical service or equipment being requested is medically necessary and justifiable for the patient's condition.
What information must be reported on certificate of medical necessity?
The certificate of medical necessity must include information such as the patient's diagnosis, treatment plan, healthcare provider's information, and justification for the medical service or equipment.
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