If a procedure or service is excluded from a members plan benefits, can we obtain authorization if we are able to establish medical necessity?
Related Questions
- Why is NIA asking for a date of service when authorizing a procedure? Do physicians have to obtain authorization before they call to schedule an appointment?
- If a procedure or service is excluded from the members plan benefits, can we obtain authorization if we are able to establish medical necessity?
- Is there an appeal process that allows enrollees to obtain benefits for a drug excluded from the Empire Plan Flexible Formulary?
