02/12/2026
Insufficient Med Necessity Documentation
Insurance companies deny claims when documentation doesn't demonstrate ongoing medical necessity.
Red flags that trigger denials:
✓ Vague subjective complaints
✓ No functional outcome measures
✓ Missing re-examination findings
✓ Copying forward previous visit notes
Medical necessity denials account for 40% of all insurance claim denials. With an average claim value of $75, just 10 denials weekly costs you $3,000 monthly.
The Fix:
✓ Document specific, measurable improvements or decline
✓ Perform and document re-examinations every 10-12 visits
✓ Connect treatment to specific functional goals
✓ Use SOAP note templates with built-in medical necessity language
Contact Us:
📞866 446 2686
