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Provider Medical Policies | Anthem.com

    https://www.anthem.com/provider/policies/clinical-guidelines/
    Medical policies and clinical utilization management guidelines help us determine if a procedure is medically necessary. Visit Anthem.com to learn more about how these policies are used to determine patient coverage and medical necessity.

ADMIN.00004 Medical Necessity Criteria - Anthem

    https://www.anthem.com/dam/medpolicies/abcbs/active/policies/mp_pw_a044145.html
    Medical Policy. Subject: Medical Necessity Criteria. Document #: ADMIN.00004. Publish Date: 07/06/2022. Status: Reviewed. Last Review Date: …

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 …

Clinical Criteria - Anthem

    https://www.anthem.com/ms/pharmacyinformation/clinicalcriteria/home.html
    This page provides the clinical criteria documents for all injectable, infused, or implanted prescription drugs and therapies covered under the medical benefit. The effective dates …

Clinical Criteria - Anthem

    https://www.anthem.com/ms/pharmacyinformation/clinicalcriteria.html
    This page provides the clinical criteria documents for all injectable, infused, or implanted prescription drugs and therapies covered under the medical benefit.The effective dates …

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 …

An overview of our medical necessity review process

    https://providernews.anthem.com/california/article/an-overview-of-our-medical-necessity-review-process-1
    Dec 1, 2019 • Policy Updates / Medical Policy & Clinical Guidelines. A medical necessity review may be called many things - including utilization review (UR), …

CG-MED-21 Anesthesia Services and Moderate …

    https://www.anthem.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_a050123.html
    Revision based Pre-merger Anthem and Pre-merger WellPoint Harmonization. ... Clinical guidelines approved by the Medical Policy & Technology …

Medical necessity review process overview - Anthem

    https://providernews.anthem.com/california/article/medical-necessity-review-process-overview
    Experienced clinicians review requests for services using medical criteria, established guidelines and applicable medical policies. ... If you are the treating …

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

    https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_c171906.html
    Clinical guidelines approved by the Medical Policy & Technology Assessment Committee are available for general adoption by plans or lines of business for consistent …



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