Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.
Minimum Necessary means the least amount of PHI necessary to accomplish the purpose for which the PHI is needed.
Medically necessary care means care that is (1) appropriate and consistent with and essential for the prevention, diagnosis, or treatment of a Patient’s condition; (2) the most appropriate supply or level of service for the Patient’s condition that can be provided safely; (3) not provided primarily
Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:
Implement or “implementation” means the development or putting into place of a policy or procedure, including the appropriate training of all relevant personnel, and the consistent and verified performance of that policy or procedure in actual practice.