And, as noted above, AI may not be used to deny, delay, or modify health care services based, in whole or in part, on medical necessity. Those determinations may be made only by a licensed ...

He was assured he had coverage. On a "Pre-Determination of Medical Necessity" form, a representative for his insurance company determined, "Authorization Not Needed." "What does that mean to you?" ...

Kaplan said she's still not sure exactly what the rationale is, except that the insurer has questioned the medical necessity of the prosthetic hand. The next step is to file an appeal with an ...

UnitedHealthcare CEO Brian Thompson had ... is also mounting ‘rigorous’ clinical reviews to determine the medical necessity of each patient's therapy, which can lead to coverage denials.

Private healthcare companies are facing increased scrutiny following the killing of UnitedHealthcare CEO ... and then questioning them about the medical necessity of the treatment.

today provided an update on its engagement with UnitedHealthcare (UNH) following the Nov 1, 2024 publication of its updated medical policy restricting access to multi-gene panel pharmacogenetic ...

Brian Thompson, the CEO of UnitedHealthcare and the father ... such as "lack of prior authorization" and "failure to prove medical necessity." Police have yet to suggest a motive for the killing ...