Letter of Medical Necessity for Therapy Services

Letter of Medical Necessity for Therapy Services

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Health plans will only pay for services that meet its medical necessity standards that are generally defined as a determination that a service is reasonable and necessary for the diagnosis or treatment of an illness or an injury. Therapists must document how the services they provide meet the requirement to treat the various types of disorders present in children and adults. This letter provides a framework for parents and professionals to appeal claim/authorization denials and get important therapy services approved.

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