When is the appropriate time to submit a Letter of Medical Necessity?
Usually, the LMN is submitted in the pre-certification / pre-authorization process, and is prepared by the provider of service. The LMN is also used in the appeals process when a claim has been denied because the insurance company does not believe the TheraTogs are medically necessary. Providers should always use the basic charting principals when recording patient encounters, keeping in mind that documentation can make the difference in an insurance company’s decision to pay a claim.
