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Who is responsible for determining Medical Necessity or for Pre-certifying the item ordered?

April 26, 2017determining medical necessity ordered pre-certifying responsible

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Who is responsible for determining Medical Necessity or for Pre-certifying the item ordered?

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If the plan or case manager requires a prescription, Letter of Medical Necessity (LMN) or other type of documentation, HOMELINK will acquire it from the prescribing physician. HOMELINK will call the plan for those items or services that require Pre-certification.