- August 12, 2021
- Posted by: Thomas Anderson
- Categories: Urgent Care, Urgent Care Billing
The CMS has already declared that understanding medical necessity is the fundamental basis of any payment. In fact accurate urgent care coding depends solely on the understanding of medical necessity. Assessing the office/outpatient E/M services that removed the system based on any history, exams as well as a process in medical decision making is a critical aspect.
Let’s face it, one of the major challenges that are faced by any urgent care center is explaining the insurance agencies the need for a procedure. In fact, it is quite true that medical necessity and medical decision making are separate things that are often thought to be interchangeable.
The bottom line is simple for all; you cannot rely on simply diagnosis codes to get your urgent claims to paid on time. A clear understanding of medical necessity and you are more likely to get reimbursed on time!
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