Compliance
Written denial
Documented denial including explanation and physician signature.
Definition
A denial of prior authorization based on medical necessity that must be issued in writing, include an explanation of the reasons for the denial, and bear the personal signature of the Arizona-licensed medical director who reviewed and approved the denial.
Related Terms
Prior authorization
Insurer approval required before certain services are covered....
Medical necessity
Standard for determining appropriateness of a service....
Medical director
Arizona-licensed physician who reviews and signs denials....
Adverse Action
Denial or unfavorable decision based on consumer information....
Employment decision
Any decision about recruitment, hiring, employment terms, or conditions....