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medically necessary

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medically necessary
Managed care adjective Referring to a covered service or treatment that is absolutely necessary to protect and enhance the health status of a Pt, and could adversely affect the Pt's condition if omitted, in accordance with accepted standards of medical practice. See Futility.
Medically necessary, criteria  
a. Appropriate for the Sx and diagnosis or treatment of a condition, illness or injury
b. Provided for the diagnosis or the direct care and treatment of the condition, illness or injury
c. In accordance with the standards of good medical practice in the service area
d. Not primarily for the convenience of a plan member or a plan provider
e. The most appropriate level or type of service or supply which can safely be provided to the plan member

Patient discussion about medically necessary.

Q. is it ok to use drugs for medical reasons? and who is to decide when is necessary to use drugs when needed?

A. Today the most used "medical" drugs are narcotics- for pain relief, for patients who suffer extreme pain. All sorts of Codaine and Morphine types are used and on a very wide basis, and they are specially perscribed for ones who need them.

Read more or ask a question about medically necessary


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Because the Company's services ensure that paid and unpaid leave time is medically necessary and time away from work is minimized, the services are cost-effective with a relatively quick payback.
The primary cause of the discrepancy was that the first team of auditors relied mainly on documentation from suppliers, while the second team also looked at medical records and interviewed patients to confirm that the products were medically necessary, had been delivered, and were being used.
Medically Necessary Treatments Botox retained its bad reputation into the mid-twentieth century, in spite of its increasing use for legitimate, medically necessary clinical treatments.
 
 
 
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