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MEDICAL NECESSITY REVIEW FORMS

PHYSICAL AND OCCUPATIONAL THERAPY (PT/OT)

  • Treatment Form
  • Outcomes Form
  • Outcomes Form - Pediatric
  • Intake Form

GHI PT Only

  • Treatment TX Form
  • Referral Certification Form 

CHIROPRACTIC (DC) FORMS
Medical Necessity Review Forms

  • NEW Treatment Form
  • NEW Intake Form
  • NEW Outcomes Form
  • NEW Outcomes Form - Pediatric
  • Chiropractic Progress Report

 Tutorials

  • Provider Portal Functionalities and Online Medical Necessity Web-Submission Process
  • Medical Necessity Paper Submission Process



 




Go to The Spine Journal
View additional articles by Dr. Simon Dagenais, Chief Scientific Officer.

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