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Certificate of medical necessity

Jfs 01960 2025

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The document outlines the Certification of Medical Necessity for ambulance transport by the Ohio Department of Job and Family Services. It includes sections for patient information, reasons for requiring ambulance transport, medical conditions justifying the need, duration of transport necessity, and details about the attending practitioner. The form is essential for certifying that ambulance services are medically necessary for Medicaid-covered patients.

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2003	4.8 Satisfied (110 Votes)

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