Medically Necessary/Medically Appropriate definition
Medically Necessary/Medically Appropriate. With respect to the Medicare and/or Medicare Advantage Program, in order for services provided to be deemed Medically Necessary or Medically Appropriate, Covered Services must: (1) be recommended by a PROVIDER who is treating the Member and practicing within the scope of her/his license and
Examples of Medically Necessary/Medically Appropriate in a sentence
Benefits will not be available for services to a greater extent or for a longer period than is Medically Necessary/Medically Appropriate, as determined by the Carrier.