Examples of Necessity in a sentence
Preauthorization requests are reviewed and approved based on Medical Necessity, eligibility and benefits.
You can find more information about this in the Medical Necessity and Precertification section of this booklet.
For time frames of initial benefit determinations that are not based on Medical Necessity, refer to "Timing of Notice" under the "Notification of HNL’s Initial Benefit Determination" provision in the "Coverage Decisions and Disputes Resolution" section of this Policy.
If you or your Physician believes a Brand Drug is Medically Necessary, either person may request a Medical Necessity Review.
HNL’s decision will include a clear and concise explanation of the reasons for Our decision, a description of the criteria or guidelines used and the clinical reasons for the decisions regarding Medical Necessity.