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Healthfirst Case

Satisfactory Essays

After a review of the clinical information provided by Integra Partners, LLC, the Medical Director has determined that enteral formula is not medically necessary. Healthfirst covers enteral formulas for members with feeding tubes or who have specific nutritional problems. Where the member is able to take food and fluids by mouth, and there is no clinical information (height, weight, medical problems that influence nutritional state) to support the medical necessity for enteral formulas, the request must be denied. Healthfirst will review additional information you

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