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Medical Necessity Guidelines | Tufts Health Plan

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines
    Point32Health is the parent organization of Tufts Health Plan and Harvard Pilgrim Health Care. Together, we're delivering ever-better health care experiences to everyone in our diverse communities. © 2023 Tufts Associated Health Plans, Inc.

Medical Necessity Guidelines: Reconstructive and

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/reconstructive-cosmetic
    Medical Necessity Guidelines are developed for selected therapeutic or diagnostic services found to be safe and proven effective in a limited, defined population …

Medical Necessity Guidelines: Rehabilitative

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/rehab-services-st
    Tufts Health Plan has concluded the following diagnoses have a medical basis that can result in speech disorders. Rehabilitative speech therapy will be covered for …

Medical Necessity Guidelines: Guardant 360 CDx

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/guardant-360
    Tufts Health Unify* – OneCare Plan (a dual-eligible product); Fax: 857.304.6304 * The MNG applies to Tufts Health Unifymembers unless a less …

Medical Necessity Guidelines: Continuous Glucose …

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/cgms-diabetes-mgmt
    Medical Necessity Guidelines: Continuous Glucose Monitoring and Diabetes Management Devices 6705972 1Continuous Glucose Monitoring and Diabetes …

Medical Necessity Guidelines: Mohs’ Micrographic …

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/mohs-surgery
    Medical Necessity Guidelines: Mohs’ Micrographic Surgery (MMS) Effective: September 1, 2022 Prior Authorization Required If REQUIRED, submit supporting clinical …

Medical Necessity Guidelines: Breast Cancer Index

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/breast-cancer-index
    Tufts Health Unify* – OneCare Plan (a dual-eligible product); Fax: 857.304.6304 * The MNG applies to Tufts Health Unifymembers unless a less …

Plan Documentation | Tufts Health Plan …

    https://www.tuftsmedicarepreferred.org/plan-documentation
    These guidelines are used by Tufts Health Plan to determine medical necessity and appropriateness of health care services for the purpose of determining …

Medical Necessity Guidelines: Cochlear Implants

    https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/cochlear-implants
    govern. For Tufts Health Together (Medicaid), coverage may be available beyond these guidelines for pediatric members under age 21 under the Early and …

UTILIZATION MANAGEMENT GUIDELINES

    https://k12dev.tuftshealthplan.com/documents/providers/provider-manuals/comm-09-um-guidelines
    Tufts Health Plan authorizes coverage of medically necessary services that: Prevent, diagnose, alleviate, correct, or cure the worsening of conditions that endanger a …



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