Medical Policy definition
Examples of Medical Policy in a sentence
New and emerging medical technologies are evaluated on an ongoing basis by the following committees – the Interregional New Technologies Committee, Medical Technology Assessment Committee, Medical Policy Committee, and Pharmacy and Therapeutics Committee.
Health Options has a Medical Policy to help Health Options determine if services are Medically Necessary.
We will utilize our Medical Policy only for services that are Covered Services.
The Plan will review a Clinical Review request to determine if it meets approved Blue Cross and Blue Shield of Montana Medical Policy and/or level of care review criteria for medical and behavioral health services.
Covered Services are described in detail in AHCCCS Rules R9-22 (e.g., Articles 2, 5, and 12), AHCCCS Medical Policy Manual (AMPM), to which Provider must adhere, the AHCCCS Contractor Operations Manual (ACOM), to which Provider must adhere, the State Contract, Section D, Program Requirements, to which Provider must adhere, all of which are incorporated herein by reference, and may be found on the AHCCCS website (▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇▇.▇▇▇).
For further information on Hospice services consult all applicable reference materials including, Indiana Medicaid Medical Policy Manual, the Hospice Module and the Prior Authorization Module, Managed Care Programs Policies and Procedures Manual.
Individual Exchange Medical Policy ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ (▇▇▇) ▇▇▇-▇▇▇▇ Policy Number - [▇▇▇-▇▇▇-▇▇▇] Total Premium - [$XXXX.XX] Policyholder - [▇▇▇▇ ▇▇▇] Premium Mode - [Monthly] [Quarterly] Effective Date - [Month Day, Year] Your Schedule of Benefits and Policy are provided in the pages that follow.
The Committee, along with Keystone’s Medical Directors and Medical Policy Staff, look at issues such as the effectiveness and safety of the new technology in treating various conditions, as well as the associated risks.
For further information on Hospice services consult the Indiana Medicaid Medical Policy Manual, the Hospice Module and the Prior Authorization Module, Managed Care Programs Policies and Procedures Manual.
All utilization management and authorizations of Group shall be consistent with Blue Shield’s Medical Policy.