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Non-Tech : The Standard Of Medical Necessity

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To: 10K a day who wrote (2)5/9/2004 11:50:19 PM
From: 10K a day   of 4
 
Nurse case manager may not deny request for pre-authorization.

[emphasis added]

Labor Code, Section 4610(e) provides
(e) No person other than a licensed physician who is competent to
evaluate the specific clinical issues involved in the medical
treatment services, and where these services are within the scope of
the physician's practice,
requested by the physician may modify,
delay, or deny requests for authorization of medical treatment for
reasons of medical necessity to cure and relieve.
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