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Kaiser Foundation Health Plan of Washington
Kaiser Foundation Health Plan of Washington Options, Inc. CHANGES TO MEDICAL NECESSITY REVIEW CRITERIA FOR RESTORATIVE
AND COSMETIC PROCEDURES
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How to fill out changes to medical necessity
How to fill out changes to medical necessity
01
Review the medical records and patient information to determine if changes are necessary.
02
Consult with the healthcare provider or case manager to discuss the proposed changes.
03
Complete the appropriate forms or documentation required for updating medical necessity.
04
Submit the changes to the insurance company or relevant authorities for approval.
05
Follow up on the status of the changes and make any necessary revisions if needed.
Who needs changes to medical necessity?
01
Healthcare providers
02
Case managers
03
Insurance companies
04
Patients requiring changes to medical necessity
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What is changes to medical necessity?
Changes to medical necessity refer to updates or modifications made to the required medical criteria for a specific treatment or service.
Who is required to file changes to medical necessity?
Healthcare providers, insurance companies, or other relevant parties may be required to file changes to medical necessity.
How to fill out changes to medical necessity?
Changes to medical necessity can be filled out by providing updated medical information, rationale for the changes, and any supporting documentation.
What is the purpose of changes to medical necessity?
The purpose of changes to medical necessity is to ensure that the medical criteria for treatments or services are up-to-date and accurately reflect the patient's condition.
What information must be reported on changes to medical necessity?
Information that must be reported on changes to medical necessity includes the updated medical criteria, rationale for the changes, and any supporting documentation.
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