certificate of medical necessity

What is a Certificate of Medical Necessity?

certificate of medical necessity

If you’ve ever tried to use Medicaid benefits to cover medical supplies, you may have been told that you first need a Certificate of Medical Necessity (CMN). This is the insurance company’s way of saying “prove to us  that you need these supplies for your treatment.”

The name may seem big and complicated, but don’t let it overwhelm you. It’s not as tricky as it sounds. A Certificate of Medical Necessity is actually a vital part of good healthcare. It ensures that healthcare dollars are being used as efficiently as possible. And it will help you get medical supplies.

 

What is a Certificate of Medical Necessity?

A Certificate of Medical Necessity is an official state document that establishes why you need certain medical supplies. It lets the insurance company know that you’ve seen a physician, and that the physician has determined you require medical supplies as part of your treatment. A CMN usually includes important information such as the physician’s diagnosis as well as the type and quantity of supplies that are needed.

Keep in mind that not every CMN is the same. Some states have special requirements for what information needs to be included. Other states will only accept CMNs that they have issued. Because of this, you may not be able to use one state’s CMN in place of another (even if the information on them is the same). For example, someone moving from Kentucky to Mississippi wouldn’t be able to use a Kentucky Medicaid CMN in order to get Mississippi Medicaid to cover their supplies.

 

How Do I Get One?

The first step to getting a Certificate of Medical Necessity is visiting your doctor to get a diagnosis. Only a doctor or physician can determine if the supplies you need are medically necessary.

Once you’ve received your diagnosis, it’s time to contact us and enroll. We’ll handle the Certificate of Medical Necessity for you, so you won’t have to worry about it. The process is simple: once you’ve enrolled, we’ll contact your doctor and send them the correct CMN to fill out. Your doctor will return it to us, and we’ll submit it to your insurance on your behalf. If your insurance needs to authorize supplies before you can get them, we’ll handle that as well. Once that’s done,  you can start getting your medical supplies.

If you’ve already been diagnosed, then call us at 800-867-4412. Enrollment only takes a few minutes, and then we can get to work obtaining your Certificate of Medical Necessity (or any other paperwork that’s needed) so you can get the supplies you need. If you have any questions, feel free to ask. We’d be happy to help you learn more.