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A Letter of Medical Necessity (LMN) is the written explanation from the treating physician describing the medical need for services, equipment, or supplies to assist the claimant in the treatment, care, or relief of their accepted work-related illness(es).
Your doctor or other provider may be asked to provide a Letter of Medical Necessity to your health plan as part of a certification or utilization review process. This process allows the health plan to review requested medical services to determine whether there is coverage for the requested service.
Designed to fit unit size 3052 - dimension is 35 13/16 wide by 62 27/32 high. They are energy efficient and ideal for sound reduction for locations near airports, busy roadways, or other noisy environments.
Form 3052 is completed for initial referrals for PHC and CAS, and for referrals for people whose initial medical need for services was temporary. If a person began services based on a temporary need and the need becomes ongoing, a new Form 3052 is required.
It requires completion by qualified health care professionals and includes sections on the residents medical history, current health status, allergies, substance abuse, risk factors for falls, cognitive and behavioral status, nutritional needs, and medication management.
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