Proving Medical Necessity

System can be used to document medical necessity with objective test results and reports. Wireless range of motion testing device or muscle strength testing device.

P.R.O.O.F. Preferred not only easily creates reports to submit for insurance reimbursement; It also creates reports necessary to get the patient approved for more visits if necessary with clear documentation that is easy-to-understand.
The reports compare the patient’s range of motion with the published AMA guidelines clearly itemizing improvement and limitation on any test date during the treatment period. For documenting muscle weakness, the reports compare the patient’s left with right side for each muscle (asymmetric muscle strength) if the muscle weakness is deemed to be Grade 4 or worse. (if applicable) The system prints out limitation at any time during the treatment period, thus clearly being able to document limitation or impairment and demonstrate improvement over time.

According to healthinsurance.com, medical necessity is defined as follows:

“Health insurance companies provide coverage only for health-related services that they define or determine to be medically necessary. Medicare, for example, defines medically necessary as: “Services or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice.”

Medical necessity refers to a decision by your health plan that your treatment, test, or procedure is necessary for your health or to treat a diagnosed medical problem.

Most health plans will not pay for healthcare services that they deem to be not medically necessary. The most common example is a cosmetic procedure, such as the injection of medications (such as Botox) to decrease facial wrinkles or tummy-tuck surgery. Many health insurance companies also will not cover procedures that they determine to be experimental, or not proven to work.
Not Sure That It’s Covered, Check with Your Health Plan

It’s important to remember that what you or your doctor defines as medically necessary may not be consistent with your health plan’s coverage rules. Before you have any procedure, especially one that is potentially expensive, review your benefit handbook to make sure it is covered. If you are not sure, call your health plan’s customer service representative.”

Definition found at : http://healthinsurance.about.com/od/healthinsurancetermsm/g/medical_necessity_definition.htm