Hot Topics from the KMC University Helpdesk | May 27, 2021

The payer’s definition of medical necessity is the key element in compliant third-party billing. Consider it the rule-book that is provided for the practice to follow to know when to expect payment from the payer vs. the patient. Understanding Medicare’s medical necessity definition is critical because so many other payers use that one as a basis. Watch this quick training where Kathy breaks the definition down into management parts so providers can digest the most important aspect of when it’s ok to expect payment from a third-party payer and when it’s not.

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