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.
Letter of Medical Necessity. Sample letter that you can submit with either the initial claim to support the medical necessity of treatment with SIMPONIÂ® for your patient or submit it to support the medical necessity of treatment with SIMPONIÂ® when requesting reconsideration of a denied claim. Click here for the sample letter.