Medical necessity sits at the intersection of clinical judgment, coverage policy, and payer scrutiny, and on this episode Stuart Newsome, VP of RCM Insights, unpacks what it really means. Joined by Viveka Jagadeesan (Enablement Manager), Lindsey Nelson (Director of Product Marketing), Christina Harkins (Senior Revenue Cycle Manager), and Angie Adams (VP Clinical & Patient Engagement), the group explores Medicare error data, CERT audits, recoupment risk, NCD vs. LCD nuances, and how AI-driven policy intelligence can support medical necessity on both the front and back end of the revenue cycle.
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