Medical Necessity: A Major Compliance Issue and Risk

Send us Fan MailPhysicians may believe a test or procedure is medically necessary, but payers make the final determination. In this episode, Captain Integrity Bob Wade details medical necessity and the implications for Stark Law compliance. Hear why payers make the medical necessity determination, patients are in control, we can compensate a physician if the patient desires additional services, what the Medicare payment rules say, and examples from the medical field. Learn more at CaptainIntegrity.com

What this episode covers

Send us Fan Mail Physicians may believe a test or procedure is medically necessary, but payers make the final determination. In this episode, Captain Integrity Bob Wade details medical necessity and the implications for Stark Law compliance. Hear why payers make the medical necessity determination, patients are in control, we can compensate a physician if the patient desires additional services, what the Medicare payment rules say, and examples from the medical field. Learn more at CaptainInt...

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How long is this episode of Stark Integrity?

This episode is 20 minutes long.

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This episode was published on January 25, 2023.

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