Medical Necessity Form (CMN Form)



As a healthcare provider, it is important for you to be familiar with the insurance coverage requirements for your patients to ensure that they get the best possible care. 

When you diagnose your patients and formulate a treatment plan for them, it is imperative that you take a glance at the patient’s insurance provider, and see if the company can provide coverage for the treatment, service, or equipment that you have suggested. 

For the same, you need to fill out a Certificate of Medical Necessity Form. In the following sections, let’s explore the nitty-gritty of this form, and why you should digitize it. 

What Is A Certificate of Medical Necessity Form?

The Certificate of Medical Necessity Form, also known as a Durable Medical Equipment Certificate, specifies the necessity of a particular medical treatment, service, or piece of equipment for a patient’s diagnosis.

It is filled out by the healthcare provider and required by the insurance company to establish the need for medical intervention. 

It typically includes the patient’s diagnosis information, the details about the medical equipment or service required, the medical justification for the same, and the details of the healthcare provider prescribing the service/equipment. 

Why Is This Form Required? 

A Certificate of Medical Necessity Form is required to establish the need for medical intervention and to seek coverage for a particular treatment, equipment, or service from the insurance company. Once the doctor fills out this form, the insurance company reviews it and assesses whether the requested equipment/treatment meets its coverage criteria. 

Why Should You Digitize The Certificate of Medical Necessity Form?

Digitizing this form serves a plethora of benefits, listed as under: 

  1. The digitized medical form can be completed and submitted faster as compared to paper forms, thereby avoiding delays in obtaining the required service or equipment. 
  2. In the digitized Certificate of Medical Necessity Form, you can implement validation checks to ensure that all required fields are completed, which further reduces rework. 
  3. The digitized form can be remotely accessed, thereby facilitating faster approvals
  4. The form can be submitted anytime around the clock
  5. The form can be stored securely with the deployment of access controls, ensuring the confidentiality and integrity of patient information
  6. The digital form will be HIPAA-compliant, thereby enhancing data privacy and security.
  7. With the digitized form, the doctor can maintain detailed audit trails to track submissions, approvals, and any changes made to the form
  8. The digital Certificate of Medical Necessity Form can be easily integrated with the EHR, which further ensures consistency of patient data and automated workflows. 

How To Digitize The Form? Best Practices To Follow 

As a front desk manager, it is time you let go of all the cumbersome paperwork and digitize the Certificate of Medical Necessity Form to ensure more streamlined operations. Here are some things to keep in mind: 

  1. Use a HIPAA-compliant form builder to create your form and integrate it with your EHR
  2. Ensure that the form has an easy interface and is compatible with all types of software and devices. 
  3. After filling out the digitized form, make sure to send it to the insurance provider in a secure manner. It could be a secure text message
  4. Implement all security measures such as encryption, access controls, and data validation checks to keep patient data secure. 
  5. Make sure that the form complies with the legal requirements of your jurisdiction

Note: Some jurisdictions require the informed consent of the patient as well on the form. Make sure to include it on your Certificate of Medical Necessity Form, if applicable. 

How Can Emitrr Help You Digitize The Certificate of Medical Necessity Form?

Emitrr offers 1000+ forms that you can download and customize for free. Here’s how we can help you digitize your Certificate of Medical Necessity Form: 

  1. You can download the Certificate of Medical Necessity Form available here and customize it as per your requirements
  2. Alternatively, if you already have a form, you can send it to us and we’ll digitize it for you absolutely free of charge
  3. Emitrr’s secure and HIPAA-compliant texting services will allow you to send the form securely to the insurance provider.  
  4. Emitrr integrates with 1000+ software, which can benefit you big time. Check out this link to see if Emitrr integrates with your EHR: 

Going paperless is the way forward if you want to automate processes and provide quality patient care. If you wish to get FREE assistance with digitizing your forms, reach out to us now!