Medical Necessity

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Description

Prevent Unnecessary Write-Offs and decrease Medical Necessity Denials with Real-Time Screening and Alerts.

The automated medical necessity means health care services provided to patients based on credible scientific evidence governed by terms of the applicable plan documents to exercise clinical judgment.

“Multimillion rules medical necessity Engine used by insurance companies to automate their medical claims adjudication processes, bringing high operational efficiency with 94% automation rate on Claim item & 75% on full invoice level.”

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