Hey there, We’re Shivang & Tania. Each week, we write in plain English (and some sass) about how health insurance works, why claims get denied, and how patients and healthcare teams can get paid or reimbursed. If you’re new here, we recommend you start with RCM 101: How Healthcare Gets Paid, Eventually, Maybe

Dr. Singh recommended a hereditary-cancer test because Biscuit’s family history suggested that he might carry an inherited cancer risk. Before BHC would agree to cover the test and reimburse the laboratory, however, the insurer wanted to conduct its own medical-necessity review.

Biscuit had already completed the difficult work of reconstructing which relatives had cancer, what kind they had, and how old they were when they were diagnosed. Family medical histories are rarely organized with the precision insurers would prefer. A family can remember every detail of a cousin’s wedding from 1997 while describing a serious diagnosis as “some stomach thing.”

Biscuit eventually confirmed that his maternal aunt had ovarian cancer at 46. Dr. Singh believed a hereditary-cancer panel could help determine whether Biscuit carried a genetic variant associated with an increased cancer risk. The result could change the screening or counseling Biscuit receives and might also provide useful information for other members of his family.

The test could not predict Biscuit’s future. It could identify an inherited risk that his care team should understand.

Dr. Singh placed the order, and Biscuit assumed the decision had been made. The clinic then explained that BHC still needed to decide whether the test met the conditions under which his insurance plan would cover it.

Dr. Singh and BHC were answering different questions. Dr. Singh was deciding whether the test was clinically appropriate for Biscuit and could improve his care. BHC was deciding whether Biscuit’s plan would cover the test and reimburse the laboratory based on the plan’s benefits, medical policy, and the records submitted.

Both decisions involve medicine. Only one determines whether BHC intends to pay.

In health insurance, medical necessity is one of the standards a payer uses to decide whether it will cover a healthcare service for a particular member and reimburse the provider for delivering it.

The payer compares the requested service, the patient’s documented circumstances, and the medical evidence with the rules governing that patient’s insurance plan. Those rules may come from federal or state law, the plan document, a government coverage determination, or the payer’s own medical policy.

For Biscuit, BHC may consider whether his family history suggests an inherited cancer risk, whether the requested panel is appropriate for that risk, whether the result could change his care, and whether the records submitted establish those facts.

Dr. Singh’s recommendation is an important part of the request. It does not, by itself, require BHC to cover the test. The insurance plan may require additional evidence before the payer authorizes the service or reimburses the laboratory.

A medical-necessity review can therefore end in several ways. BHC may decide that Biscuit does not satisfy its clinical criteria. It may consider the requested panel too broad for the suspected condition. It may question whether the result would change Biscuit’s care. It may also receive records that leave the necessary facts unclear.

Each problem calls for a different response. Denial letters are not always generous enough to explain which one occurred.

For Biscuit, medical necessity matters enormously. It can determine whether BHC authorizes the test and whether the laboratory can seek reimbursement. It is still one question within a larger reimbursement process.

Biscuit’s test begins with Dr. Singh’s clinical decision. From there, BHC must answer four separate reimbursement questions: is the test available under Biscuit’s benefits, does he satisfy the clinical criteria, is prior authorization required, and does the final claim meet the rules for payment?

A payer may review several of these questions together or in a different order. Separating them helps explain how BHC can approve the clinical need for a test while the laboratory still encounters a payment problem.

Dr. Singh selects a specific hereditary-cancer test and records why Biscuit needs it. The order should identify the panel and explain how the result could affect Biscuit’s screening, counseling, or other care.

Specificity matters because “genetic testing” describes a large range of services. Testing one known family variant raises different clinical, coding, and reimbursement questions from sequencing a broad panel containing dozens of genes.

Dr. Singh’s order establishes the clinical reason for testing. BHC then evaluates that request under Biscuit’s insurance plan.

Biscuit’s benefit plan determines whether hereditary-cancer testing can qualify for coverage. The plan may include genetic testing broadly, limit it to certain circumstances, require genetic counseling, restrict which laboratories may be used, or exclude particular types of testing.

The benefit plan lists the services available to Biscuit, while BHC’s medical policy supplies the clinical criteria for those services. Finding a favorable medical policy therefore answers only part of the question. Biscuit must also have the relevant benefit under his specific plan.

This is the medical-necessity decision.

BHC compares Biscuit’s documented circumstances with the criteria in its hereditary-cancer policy. The review may consider which relative had cancer, how closely that person is related to Biscuit, the cancer type, the age at diagnosis, the genes included in the requested panel, and how the result could change Biscuit’s care.

The records submitted with the request must give BHC enough information to apply those criteria. Biscuit’s actual family history may qualify, yet “family history of cancer” leaves the reviewer unable to determine whether it does.

A favorable decision means that BHC considers the requested test clinically eligible for coverage for Biscuit based on the records reviewed.

Some insurance plans require BHC to review the request before the laboratory performs the test. When prior authorization applies, the approval may identify the member, test, billing code, laboratory, diagnosis, and period during which the service can be performed.

For genetic testing, the exact laboratory and panel can matter because different tests may contain different genes or use different billing codes. A broader panel, different laboratory, expired authorization, or mismatched billing code can create a payment problem even when Biscuit’s clinical history satisfies the medical policy.

An approval gives the laboratory reasonable confidence that BHC has reviewed the request and accepted it based on the information available at that time. The test eventually performed and billed must match the approved request.

After performing the test, the laboratory submits a claim to BHC. Claim adjudication is the process BHC uses to determine the allowed amount, the insurer’s payment, and any amount assigned to Biscuit.

BHC may review whether:

BHC may reimburse the laboratory, assign part or all of the allowed amount to Biscuit’s cost-sharing, request additional information, or deny the claim.

Medical necessity addresses whether Biscuit satisfies the clinical requirements for the test. Claim adjudication brings that decision together with the remaining benefit, authorization, coding, eligibility, network, and payment rules.

This is why the word covered causes so much confusion. It can mean that the service exists within the plan’s benefits, that BHC approved the clinical request, or that the final claim produced reimbursement.

Insurance gave one word three jobs. It has gone about as well as expected.

All of this leaves Biscuit with a reasonable complaint. Dr. Singh already decided that the test could help him. How did BHC acquire the authority to make a separate clinical decision about reimbursement?

Insurers began reviewing medical necessity once third parties assumed responsibility for healthcare costs.

Before modern health insurance, decisions about care were largely made between patients and clinicians, with patients generally paying providers directly. That changed as private insurance expanded during the 1930s and 1940s. By the end of World War II, more than 30 million Americans had private hospital insurance.

As insurers and employers assumed greater financial responsibility, they needed to define what their plans would pay for. Broad exclusions for experimental treatment, custodial care, and cosmetic procedures addressed some questions—but not whether a particular patient needed to be admitted or remain hospitalized for seven days.

Hospitals began monitoring the use of scarce beds during World War II. By the 1950s, insurers were reviewing whether hospital services already provided were appropriate for reimbursement. In the early 1960s, more than 60 Blue Cross plans reviewed hospital admissions, while more than 50 reviewed lengths of stay. Some required physicians to certify that hospitalization was necessary.

The foundations of modern utilization review were already in place: clinical criteria, physician certification, medical-record review, and payment consequences. The National Academies’ history of utilization management traces this development.

The federal government assumed a larger role when Congress created Medicare in 1965. The law prohibited payment for most services that were not “reasonable and necessary” for diagnosing or treating illness or injury—a standard that remains in §1862 of the Social Security Act.

That division still shapes American healthcare: clinicians decide what care to recommend, while payers decide whether it satisfies the reimbursement rules of the patient’s plan. Modern prior authorization grew from this system. It kept the clinical review and added a portal.

The organization responsible for covering the patient usually determines which medical-necessity rules apply. Original Medicare, Medicare Advantage plans, state Medicaid programs, and commercial health plans operate under different legal and contractual frameworks.

The exact rules vary, although most reviews examine a similar group of questions.

The first question is whether the patient’s plan covers the type of service being requested. If genetic testing is excluded from a particular benefit plan, the payer can deny coverage without deciding whether the test would be clinically useful for Biscuit.

When the service is eligible for coverage, the payer examines the patient’s clinical circumstances. The policy may require a particular diagnosis, symptom, family history, risk level, previous test result, treatment history, or unsuccessful attempt with another service.

The payer also considers the evidence supporting the requested service. For a diagnostic test, this may include whether the test can detect the relevant genetic change accurately, whether that change is meaningfully associated with disease, and whether learning the result can improve a clinical decision.

The requested version of the service matters as well. A payer may agree that genetic testing is appropriate while disagreeing with the specific panel, number of genes, testing frequency, or laboratory method selected.

Finally, the payer needs documentation showing how the patient meets each requirement. Reviewers generally cannot apply facts that never reach them.

The authority behind these decisions depends on the patient’s coverage.

Original Medicare begins with federal law. A service generally must fall within a benefit category that Medicare is legally permitted to cover, avoid a statutory exclusion, and satisfy Medicare’s “reasonable and necessary” standard.

CMS can issue a National Coverage Determination, or NCD, that establishes whether Medicare covers a service across the country. When no controlling national rule exists, a regional Medicare Administrative Contractor may issue a Local Coverage Determination, or LCD, for the states and territories within its jurisdiction.

CMS considers clinical experience and relevant medical, technical, and scientific evidence when developing a national coverage determination. The process generally includes public notice, an opportunity for comment, and an explanation of the final decision. CMS explains the Medicare coverage process here.

Medicare Advantage plans are private plans that provide Medicare benefits under contracts with the federal government. They generally must cover the basic benefits available through Original Medicare and follow applicable Medicare statutes, regulations, NCDs, and LCDs.

When those sources do not fully establish coverage criteria, a Medicare Advantage plan may create publicly accessible internal criteria based on current evidence from widely used clinical guidelines or medical literature.

The plan’s individual coverage decision must also consider the member’s medical history, physician recommendations, and clinical notes. These requirements appear in 42 CFR §422.101.

Medicaid is jointly funded by federal and state governments and administered through individual state programs. The definition and application of medical necessity can therefore vary considerably by state.

A state may administer benefits directly or contract with managed-care organizations to provide coverage. Federal rules allow Medicaid programs and managed-care plans to use medical-necessity criteria and utilization controls, subject to specific protections.

For Medicaid managed care, the plan’s definition of medically necessary services cannot be more restrictive than the definition used by the state Medicaid program. Authorization criteria must be applied consistently, and a decision to deny or reduce a requested service must be made by someone with appropriate expertise. These requirements are described in 42 CFR §438.210.

Commercial coverage makes the patient’s exact insurance product especially important.

In a fully insured employer plan, an insurance company collects premiums and assumes the financial risk of paying members’ claims. The plan is subject to applicable federal requirements and the insurance laws of the state where the policy is issued.

In a self-funded employer plan, the employer generally pays its employees’ healthcare claims using its own funds. An insurance company may still administer the network, process claims, and issue insurance cards, which is why the distinction is not always visible to the employee. These plans are primarily regulated under the federal Employee Retirement Income Security Act, commonly called ERISA, and many state insurance mandates do not apply to them in the same way.

The definition of medical necessity commonly appears in the governing plan document. The insurer or plan administrator then translates that definition into medical policies, clinical criteria, review procedures, and patient-level decisions.

Federal claims-and-appeals rules provide important protections, although they do not establish one national medical-necessity definition for every commercial plan. State law, the funding arrangement, the plan document, the service involved, and the policy in effect on the date of care can all influence the answer.

By the time Biscuit’s request reaches Otis, BHC has already converted a large body of medical evidence into a much shorter set of coverage criteria.

Professional organizations review this evidence and publish clinical guidelines or recommendations. For hereditary cancer, those organizations may include the National Comprehensive Cancer Network, the American Society of Clinical Oncology, the American College of Medical Genetics and Genomics, the American College of Obstetricians and Gynecologists, the U.S. Preventive Services Task Force, and specialty medical societies.

A payer’s policy team may review those guidelines alongside peer-reviewed studies, technology assessments, regulatory status, expert opinions, benefit terms, and its own evaluation of the evidence.

The policy team then converts that material into criteria that reviewers can apply consistently to individual requests.

For Biscuit, BHC’s criteria might ask:

This level of detail appears in real commercial medical policies. That is how broad medical evidence becomes a question on Otis’s screen. Research informs clinical guidelines. BHC interprets the evidence and writes a medical policy. The policy becomes a set of patient-level criteria. Otis compares those criteria with the information BHC received about Biscuit.

A recommendation from a respected clinical organization can influence a payer’s medical policy. It does not automatically require every payer to cover the recommended service.

The National Comprehensive Cancer Network, commonly called NCCN, is highly influential in oncology. It is a professional clinical organization rather than a government regulator.

BHC may consider an NCCN recommendation alongside studies, other professional guidelines, technology assessments, questions about clinical utility, and the evidentiary standards used by its own policy team. Another payer can review the same materials and write different coverage criteria.

A law, regulation, benefit mandate, or plan provision may require a payer to follow a particular authority in some circumstances. Without such a requirement, commercial payers may adopt criteria that are broader, narrower, or otherwise different from a clinical guideline.

The law still places guardrails around the decisions produced by those policies. A medical-necessity denial must follow the claims-and-appeals procedures that apply to the patient’s plan.

Depending on the plan and the circumstances, a patient may have access to an internal appeal and an independent external review. Federal external-review rules recognize medical necessity, appropriateness, healthcare setting, level of care, and effectiveness as decisions involving medical judgment. Those protections appear in 45 CFR §147.136.

State utilization-review laws may create additional requirements for fully insured plans. Depending on the state, these laws can address evidence-based criteria, reviewer qualifications, policy disclosure, decision deadlines, and appeal rights. Self-funded employer plans are generally regulated at the federal level under ERISA, so state insurance mandates often have a more limited role.

NCCN can carry considerable weight in the review. It does not function as an authorization code.

Biscuit may satisfy BHC’s medical policy in real life. The records submitted to BHC still need to demonstrate that he meets it.

In our fictional example, BHC’s policy covers hereditary-cancer panel testing for certain people whose documented family histories include qualifying cancers in sufficiently close relatives and whose test results could meaningfully guide care.

Biscuit’s maternal aunt had ovarian cancer at 46. His actual family history appears to satisfy the central requirement.

Otis cannot review the full conversation between Biscuit and Dr. Singh. He cannot see the family tree they discussed or hear the details Biscuit confirmed with his mother after the appointment. He can review only the information submitted to BHC.

The initial request says: “Family history of cancer.”

The statement is accurate and almost useless.

A maternal aunt with ovarian cancer at 46 can carry a very different hereditary risk from a distant cousin with skin cancer at 83. Both situations can be reduced to “family history of cancer.”

To apply BHC’s policy, Otis needs to know which relative had cancer, how that person is related to Biscuit, the type of cancer, the age at diagnosis, the affected side of the family, why Dr. Singh selected this panel, and how the result could change Biscuit’s care.

Otis’s review therefore looks something like this:

Each missing detail corresponds to a question in BHC’s policy. Biscuit’s actual history may meet the criteria. The packet Otis received does not establish that.

BHC sends Biscuit a letter stating that the test is “not medically necessary.” In this fictional case, the payer has concluded that the information submitted does not demonstrate that Biscuit meets the plan’s medical-necessity criteria.

The denial language sounds broader than the decision BHC actually made. It can leave Biscuit believing that the insurer reviewed his complete medical history and decided that the test had no clinical value.

That explanation identifies an evidence gap in the request. Other medical-necessity denials can involve a genuine disagreement with the service. The payer may believe that the patient’s history falls outside its criteria, the selected panel is too broad, another test should be used first, or the evidence does not establish sufficient clinical utility.

The same denial phrase can therefore describe two different problems:

The first problem may require an appeal challenging how the policy was applied, stronger medical evidence, an exception request, or a different clinical approach.

The second problem requires the provider to submit the missing facts and connect them clearly to the relevant policy criteria.

A vague denial can make it difficult to tell which problem occurred. The patient or provider may need to request the exact policy, the criterion used, the denial rationale, and a copy of the information reviewed.

Documentation connects the patient’s clinical circumstances to the payer’s reimbursement rules. When that connection is missing, the reviewer may be unable to determine that the patient qualifies for coverage.

Biscuit: “That is a confident conclusion from a company that still does not know which aunt had what.”

Prior authorization gives BHC an opportunity to evaluate Biscuit’s test before it is performed. Depending on the service and insurance plan, the payer may apply medical-necessity criteria again later.

For a one-time genetic test, another review may occur when BHC processes the claim, requests the medical records, or considers an appeal. 

For ongoing care, a payer may conduct a concurrent review while treatment is underway to decide whether additional hospital days, therapy sessions, or another period of care qualifies for continued coverage.

A retrospective review examines the medical necessity of care after it has already occurred. A post-payment audit takes place after the claim has been paid and can lead the payer to request money back. Medical-necessity criteria may also influence how frequently a service is covered, where care can be delivered, or whether another treatment must be attempted first.

Each review occurs at a different point and can produce a different consequence. The central question remains the same: did the patient’s documented circumstances satisfy the coverage rules that applied to the service on that date?

An earlier authorization records the payer’s pre-service decision and reduces uncertainty for the patient and provider. Its practical value depends on the completed service matching the test, laboratory, timing, and other details BHC reviewed.

The answer can also change across patients or over time. A different insurance product, family history, policy version, test panel, or set of medical records can produce a different result.

Medical necessity belongs to a specific request: this patient, this plan, this service, this evidence, and this date.

For Biscuit, the immediate problem is simpler. BHC’s first review was based on an incomplete account of his family history. His next step is to find the missing connection between his medical record and BHC’s policy.

Biscuit and Dr. Singh’s team can respond effectively once they understand why BHC denied the request. Their next step is to identify the policy criterion involved and submit the clinical facts that address it.

They ask BHC for the exact medical policy, the relevant plan provision, and the specific reason for the denial. They also confirm that BHC reviewed the request under Biscuit’s actual insurance product and used the policy version in effect on the date of the decision.

Dr. Singh’s team then compares each requirement with Biscuit’s chart.

The resubmitted packet identifies Biscuit’s maternal aunt, her ovarian-cancer diagnosis, her age at diagnosis, and the maternal side of the family. It explains which hereditary-cancer panel Dr. Singh selected, why the genes on that panel are relevant to the suspected risk, and how the result could change Biscuit’s screening and counseling.

The team submits relevant evidence in a structure Otis can follow. Each clinical fact connects directly to a criterion in BHC’s policy.

On the second review, Otis can see that Biscuit satisfies the fictional policy, and BHC approves the authorization.

Biscuit’s medical circumstances did not change between the denial and the approval. His aunt’s diagnosis remained the same. The second packet finally gave BHC a complete and usable account of those circumstances.

Better documentation cannot correct every denial. It cannot override a benefit exclusion, create clinical evidence that does not exist, or make a patient satisfy criteria the patient genuinely does not meet.

It can change the result when the payer’s decision arose from information that was missing, vague, or disconnected from the applicable rule.

Biscuit’s story shows how a medical-necessity decision can be prevented or challenged more effectively when everyone understands the payer’s actual question. Patients, providers, RCM teams, and market-access teams each control a different part of that connection.

After receiving a medical-necessity denial, find out what the payer actually decided.

Ask which plan provision and medical policy were used, which specific criterion was not met, and whether the payer believes the service is excluded, unsupported for your circumstances, clinically inappropriate, or insufficiently documented.

Request the denial rationale in writing and obtain the version of the policy that applied when the decision was made. Ask the provider what records and information were submitted with the original request.

If your medical history appears to satisfy the policy, compare the missing criterion with the documentation the payer received. If the disagreement concerns the policy itself, the appeal may need to explain why the policy was applied incorrectly, why another rule governs the request, or why medical evidence supports coverage in your circumstances.

Depending on the plan and denial, an internal appeal and independent external review may also be available.

Please do not send Pre·imbursed your medical records, member ID, date of birth, or other private health information. We can explain the maze without collecting souvenirs from it.

A note stating that a test was ordered proves that a clinician requested it. The payer still needs the clinical facts required by its policy.

Before submitting a request, identify the current policy for the patient’s exact plan. Determine which variables control the decision, such as the diagnosis, symptoms, treatment history, family relationship, age at diagnosis, previous testing, risk score, suspected syndrome, selected panel, or expected clinical use of the result.

Document those facts specifically and place them where a reviewer can find them.

For Biscuit, “maternal aunt with ovarian cancer diagnosed at 46” provides usable information. “Family history of cancer” leaves most of the policy unanswered.

Clear documentation does not require the longest possible clinical note. It requires the right facts, the clinician’s reasoning, and an understandable connection between the two.

RCM and prior-authorization teams convert the payer’s medical policy into the information collected and submitted for each patient.

Each coverage criterion should become a required data element, document, validation, or question in the workflow. When a payer requires the affected relative, relationship, cancer type, age at diagnosis, family side, selected test, and expected effect on care, the team should collect those details before submitting the request.

The workflow should also confirm the payer, insurance product, policy version, authorization pathway, required form, submission destination, and expected decision time. Two plans carrying the same insurer’s logo may use different benefits, criteria, or processes.

Cases should be separated into three groups:

The third group deserves attention before submission. It is a common source of avoidable denials.

A favorable study or clinical guideline shows that experts support a service under particular circumstances. The payer’s medical policy reveals how that evidence has been translated into reimbursement criteria.

Compare the product’s supporting evidence with the payer’s actual requirements. Determine where the policy narrows the guideline and which issue drives that difference.

The payer may question analytical validity, clinical validity, clinical utility, patient selection, panel size, testing frequency, or whether the result changes clinical management. Each concern suggests a different evidence or engagement strategy.

If payers already agree that a test is accurate and remain unconvinced that the result changes care, additional accuracy data may leave the central concern unresolved. Evidence demonstrating changes in screening, treatment, counseling, or patient outcomes may be more relevant.

Market-access teams should also examine whether providers can document the facts required by a favorable policy. Coverage criteria that depend on information missing from the ordering workflow can still produce poor access in practice.

The work extends from demonstrating the product’s value to making that value usable. Payers need criteria they can apply, providers need documentation they can supply, and operational teams need a workflow that reliably connects the two.

Regulatory authorization, clinical evidence, professional guidelines, payer coverage, coding, contracting, prior authorization, claims submission, and payment are separate parts of the same commercial path.

A weakness at any point can surface later as a medical-necessity denial or an unpaid claim.

Leaders should examine whether the evidence supports the product, whether payer policies reflect that evidence, whether providers understand the criteria, and whether patient-level workflows collect the information required for reimbursement.

A sophisticated evidence strategy can still fail operationally if Biscuit’s detailed family history becomes “family history of cancer” before the request reaches the payer.

In reimbursement, medical necessity describes a payer’s decision about whether a healthcare service qualifies for coverage and payment for a particular patient under the rules governing that patient’s plan.

The standard can protect patients and shared healthcare resources from services that are ineffective, excessive, or inappropriate. It can also compress a complicated and disputed coverage judgment into three words that reveal very little about what went wrong.

That’s this week’s lesson. Hit reply. I read everything.

Disclaimer: The content published by preimbursed (the "Newsletter") is provided for general informational and educational purposes only and reflects the opinions and commentary of the author. It does not constitute, and should not be relied upon as, medical, legal, financial, tax, insurance, or other professional advice. No physician-patient, attorney-client, fiduciary, or other professional relationship is created by reading the Newsletter or by corresponding with the author. The Newsletter is not a substitute for individualized advice from a qualified professional. Before making any healthcare, coverage, insurance, financial, or legal decision, you should consult your own physician, attorney, benefits administrator, or other licensed advisor and review your specific plan documents, policies, and applicable law. The author is not responsible for any action taken or not taken in reliance on the content herein, and you assume full responsibility for your use of the information provided. Information in the Newsletter is believed to be accurate as of the date of publication and is drawn from the sources cited. Laws, regulations, coverage rules, corporate ownership, market data, and other facts change frequently and may have changed since publication. Certain statements describe pending, recently enacted, or phased-in legal and regulatory changes whose scope, interpretation, and effective dates may shift. The author makes no representation or warranty, express or implied, regarding the accuracy, completeness, timeliness, or reliability of any content, and disclaims all liability for any errors or omissions to the fullest extent permitted by law. References to any company, organization, product, government program, or individual are made solely for purposes of news reporting, commentary, analysis, and criticism, and do not imply any endorsement, sponsorship, affiliation, or partnership. All trademarks, service marks, and trade names are the property of their respective owners and are used only for identification and descriptive purposes. Where a named party disputes a characterization or finding, the Newsletter notes that dispute. Statements concerning identified companies reflect cited reporting and the author's opinion and analysis of matters of public concern. Certain characters, organizations, and scenarios in the Newsletter, including but not limited to Biscuit, Dr. Singh, and composite payer and provider names, are fictional and used for illustration. Any resemblance to actual persons or entities is coincidental.

Disclosure: The authors are the co-founders of Converus.ai, a company that organizes payer policy information for healthcare providers, and therefore has a commercial interest in the subject matter discussed. References to Converus.ai are made only where relevant and are not paid placements. To the fullest extent permitted by applicable law, the author and preimbursed disclaim all warranties and shall not be liable for any direct, indirect, incidental, consequential, or other damages arising out of or in connection with your use of, or reliance on, the Newsletter.