Letters of Medical Necessity
O'Brien S, Parker S, Greenberg J, Zuckerman B.
Putting children first: the pediatrician as advocate.
Contemporary Pediatrics. 1997;:103-118.
This article defines the process of advocating for health care funding and gives specific examples of effective and ineffective letters for Medicaid funding. It also gives information on how to become active in community advocacy and the legislative process.
Wheelchair and Seating Evaluations
How to Write an Insurance Appeal Letter
EVERY REASONABLE EFFORT HAS BEEN MADE TO VERIFY THE ACCURACY OF THE INFORMATION. HOWEVER, THE SAMPLE LETTERS OF MEDICAL NECESSITY ARE NOT INTENDED TO PROVIDE SPECIFIC GUIDANCE ON HOW TO APPLY FOR FUNDING FOR ANY PRODUCT OR SERVICE. HEALTH CARE PROVIDERS SHOULD MAKE THE ULTIMATE DETERMINATION AS TO WHEN TO USE A SPECIFIC PRODUCT BASED ON CLINICAL APPROPRIATENESS FOR A PARTICULAR PATIENT AND APPLICATIONS TO ANY FUNDING SOURCE MUST ACCURATELY REFLECT THE FACTS UNIQUE TO INDIVIDUAL APPLICATIONS. THIRD PARTY PAYMENT IS AFFECTED BY NUMEROUS FACTORS AND ESPECIALNEEDS CANNOT GUARANTEE THE SUCCESS IN OBTAINING INSURANCE OR THIRD PARTY PAYMENTS OF ANY KIND.