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.
Medically necessary is a term used by insurers to describe medical treatment that is appropriate and rendered in accordance with generally accepted standards of medical practice. Gillian I. Russell, Terminology, in FUNDAMENTALS OF HEALTH LAW 1, 25 (American Health Lawyers Association 5th ed., 2011). Policy.