We would like you to make clear that the supplier needs documentation to get paid by the insurer. Medical necessity documentation is not inherently part of ordering a service – it is a payer requirement. We therefore suggest that you clearly outline process and show major players – ordering provider, rendering provider (supplier), and payer. If possible, would suggest also adding use cases to flesh out who is requesting the information and why.

Existing Wording:

"provides for the inclusion of appropriate documentation to support the medical necessity of the orders to facilitate documentation for the purpose of refining the order and supporting appropriate billing "

Proposed Wording:

None