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Ohio Department of MedicaidCertificate of Medical Necessity/Prescription Compression Garments Instructions: The Certificate of Medical Necessity (CAN) must be used for compression garments under the
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How to fill out certificate of medical necessity
How to fill out certificate of medical necessity
01
Obtain a copy of the certificate of medical necessity form
02
Fill out the patient's personal information including name, address, and date of birth
03
Provide information about the ordering physician, including name, address, and NPI number
04
Document the medical necessity for the requested treatment or service
05
Include any relevant medical records or test results to support the need for the treatment
06
Sign and date the form
07
Submit the completed form to the appropriate healthcare provider or insurance company
Who needs certificate of medical necessity?
01
Patients who require certain medical treatments or services that may not be covered by insurance without documentation of medical necessity
02
Healthcare providers who are ordering treatments or services that may require prior authorization or approval from insurance companies
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What is certificate of medical necessity?
The certificate of medical necessity is a document that provides justification for the medical need of a specific treatment or service.
Who is required to file certificate of medical necessity?
Medical professionals, such as doctors or therapists, are required to file a certificate of medical necessity.
How to fill out certificate of medical necessity?
To fill out a certificate of medical necessity, the medical professional must provide detailed information about the patient's condition, the recommended treatment or service, and the reason why it is medically necessary.
What is the purpose of certificate of medical necessity?
The purpose of the certificate of medical necessity is to ensure that medical treatments or services are only provided when they are medically necessary.
What information must be reported on certificate of medical necessity?
The certificate of medical necessity must include information about the patient's condition, the recommended treatment or service, and the medical professional's justification for why it is necessary.
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