Medical Necessity

The Centers for Medicare and Medicaid services (CMS) and third-party payers require medical diagnosis to justify ordering healthcare services. If you order a service that has a specific NCD or LCD, please verify the diagnosis code for that test to ensure the diagnosis information you are providing to us meets medical necessity criteria determined by CMS. If the patient’s diagnosis does not meet medical necessity criteria determined by CMS, you should notify the patient that Medicare or Medicaid is not likely to pay for the services and request them to sign a waiver of responsibility, known as an Advanced Beneficiary Notice (ABN). This waiver serves as a notice to the patient that if CMS does not cover the services due to frequency or medical necessity that the patient is responsible for the charges for those services. This notice must be given to the patient prior to the service thus allowing the patient the options provided by CMS. If the patient refuses to sign the ABN, thus choosing not to take responsibility or indicates that they do not want this testing, then the physician must weigh the necessity for the test. This information is provided to assist you in making the best possible decisions for your patient. As always, we value your trust in Principle Health Systems and appreciate your business.

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Customer Testimonials

I would have to say that working with this company has been AMAZING! My rep is exceptionally FANTASTIC in coordinating you with the proper people to obtain any itemized billing and records needed, she has DEFINITELY made my job so much easier! Thank you!

April Onofre

Started a relationship with Principle last year with Touchstone Communities in our Houston area Communities. That was the start. This was followed with our new company, ML Healthcare. We wanted to continue this partnership with Principle in our new facility, Cypress Pointe Health and Wellness. Working with Principle has been great! They are true Partners in our healthcare facilities. Our organization values our relationship with Principle, and we look forward to continuing this relationship in our new facility – Sylvan Shores Health and Wellness.

Lee Rivaz

Our Skilled Nursing Facility has used Principle Health Systems for the past three years. I have never reached out to them for assistance that I wasn’t able to connect with someone right away. They have skilled professional staff that provide excellent customer service and communication.

Karen Johnson

Fast and Friendly Service! Thank you Principle Health for keeping everyone safe during the testing process with your thorough cleanliness standards.

Priscilla Diosdado

Principle has provided great services for our companies. We provide drug and alcohol treatment services, so timeliness with tox results is extremely important. We have always found Principle and their staff to be highly professional, responsive and efficient. We strongly recommend partnering with Principle and their team for your company’s service needs.

Joe Gardzina

Great company to do business with. They have serviced my community and the residents and family were beyond pleased with their services!

Brittney Richardson

This is a top-notch lab that goes above and beyond our needs at our clinics. They have met our every need and taken the time to educate the staff whenever the need arose.

Estella Rabbani

Principle Health Systems is a very professional establishment that truly believes in customer service within and without of the organization. They are concerned about the needs of their patrons and believe in rectifying any matter with a positive lasting solution. They have amazing staff and awesome management which explains why they appear to be so successful.

Kimberly Ferrell

Fast and Friendly Service! Thank you Principle Health for keeping everyone safe during the testing process with your thorough cleanliness standards.

Priscilla Diosdado

Amazing company. The staff are complete pros and take care of their patients. Wouldn’t hesitate to recommend!

David DeCasper