Anthem Blue Cross Medical Necessity Criteria 2012

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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

THESE CRITERIA ARE USED IN THE DEVELOPMENT AND UPDATING OF MEDICAL POLICIES AND CLINICAL UM GUIDELINES. AS THESE CRITERIA MAY …

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 …

CG-REHAB-10 Site of Care: Outpatient Physical Therapy …

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_c196852.html

Note: The medical necessity of physical therapy, occupational therapy, and speech-language pathology services requested may be separately reviewed against the …

Clinical Criteria - Anthem

https://www.anthem.com/ca/ms/pharmacyinformation/clinicalcriteria.html

All clinical criteria are developed to help guide clinically appropriate use of drugs and therapies and are reviewed and approved by the CarelonRx* Pharmacy and Therapeutics …

CG-DME-22 Ankle-Foot & Knee-Ankle-Foot Orthoses

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053659.html

Medically Necessary: An ankle-foot orthosis (AFO) is considered medically necessary for ambulatory (i.e., able to walk, independently or with …

Provider Manuals, Policies and Guidelines - Anthem

https://providers.anthem.com/california-provider/resources/manuals-policies-guidelines

Provider Manuals, Policies and Guidelines Anthem Blue Cross (Anthem) is committed to supporting you in providing quality care and services to the members in our network. …

Policies, Guidelines & Manuals | Anthem Blue Cross and …

https://providers.anthem.com/wisconsin-provider/resources/manuals-and-guides

Policies, Guidelines and Manuals Anthem Blue Cross and Blue Shield (Anthem) is committed to supporting you in providing quality care and services to the members in our …

CG-ANC-06 Ambulance Services: Ground; Non …

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_c171906.html

Proper equipment may include ventilation and airway equipment, cardiac equipment (monitoring and defibrillation), immobilization devices, bandages, …

Reimbursement Policies | Anthem Blue Cross and Blue …

https://providers.anthem.com/ohio-provider/claims/reimbursement-policies

These policies serve as a guide to assist you in accurate claim submissions and to outline the basis for reimbursement by Anthem Blue Cross and Blue Shield (Anthem) …

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