Anthem Behavioral Health Medical Necessity Criteria 2023

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Provider Medical Policies | Anthem.com

https://www.anthem.com/provider/policies/clinical-guidelines/

Medical Policies & Clinical UM Guidelines. There are several factors that impact whether a service or procedure is covered under a member’s benefit plan. Medical policies and clinical utilization management (UM) guidelines are two resources that help us determine if a …

ADMIN.00004 Medical Necessity Criteria - Anthem

https://www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_a044145.html

Status: Reviewed. Last Review Date: 05/12/2022. THESE CRITERIA ARE USED IN THE DEVELOPMENT AND UPDATING OF MEDICAL POLICIES AND …

Behavioral Health Provider Resources | Anthem.com

https://www.anthem.com/provider/behavioral-health/

Behavioral Health Provider Resources. Most people don’t view their physical and mental health as separate, and neither do we. Behavioral health benefits are integrated into …

Provider Policies, Guidelines and Manuals | Anthem.com

https://www.anthem.com/provider/policies/

Policies, Guidelines & Manuals We’re committed to supporting you in providing quality care and services to the members in our network. Here you will find information for assessing …

Medical Policies and Clinical Guidelines updates

https://providernews.anthem.com/kentucky/article/medical-policies-and-clinical-guidelines-updates-february-2023

The following Anthem Blue Cross and Blue Shield (Anthem) Medical Polices and Clinical Guidelines were reviewed on November 10, 2022. To view medical policies …

CG-BEH-02 Adaptive Behavioral Treatment - Anthem

https://www.anthem.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c166121.html

The hours of services should reflect the number of behavioral targets, services, and key functional skills to be addressed, with a clinical summary justifying the …

Medical necessity review process overview - Anthem

https://providernews.anthem.com/california/article/medical-necessity-review-process-overview

Medical necessity review process overview. Dec 1, 2021 • Administrative. Within the member’s Evidence of Coverage or benefit booklet, a medical necessity …

Provider Communications

https://providernews.anthem.com/maine/article/medical-policy-and-clinical-guideline-updates-are-available-on-anthemcom-8

The following new and revised medical policies and clinical guidelines were endorsed at the May 12, 2022, Medical Policy & Technology Assessment Committee …

Medical Policies and Clinical Utilization Management …

https://providers.anthem.com/docs/gpp/nv_caid_Aug2022MPTA.pdf

Effective for dates of service on and after April 9, 2023, the following updates will apply to the AIM Specialty Health Clinical Appropriateness Guidelines for medical necessity …

Medical necessity review for appropriate level of care

https://providernews.anthem.com/virginia/article/medical-necessity-review-for-appropriate-level-of-care-2

Medical necessity review for appropriate level of care. Sep 1, 2019 • State & Federal / Medicaid. Effective since May 1, 2019, certain service requests for Anthem …

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