Independent Pharmacies: In order to send prescription renewal authorization requests electronically to all eligible prescribers in your area, your pharmacy software must be updated with a valid Surescripts Provider Identifier (SPI) number for each prescriber activated for electronic renewals.
DOCUMENTATION AND CLAIMING REMINDERS BASED ON CHART REVIEWS Medical Necessity and Claiming to Medi-Cal In order to receive reimbursement from Medi-Cal services must meet all Medical Necessity criteria. Medical Necessity has three key criteria: included diagnosis, impairment and interventions. Each element is further defined below. 1.
Boston Scientific. encourages providers to submit accurate and appropriate claims for services. It is always the providerâs. responsibility to determine medical necessity, the proper site for delivery of any services and to submit. appropriate codes, charges, and modifiers for services that are rendered. Boston Scientific recommends.