Políticas médicas y de pago

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Draft Medical Policies
Prescription Digital Health Therapies for Attention Deficit/Hyperactivity Disorder- Effective 01/1/2022
Paraspinal Surface Electromyography (SEMG) to Evaluate and Monitor Back Pain
Patient-Controlled End of Range Motion Stretching Devices
Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
Percutaneous Electrical Nerve Stimulation and Percutaneous Neuromodulation Therapy
Peripheral Artery Disease (PAD) Rehabilitation
Peripheral Subcutaneous Field Stimulation
Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia
Phototherapy for the Treatment of Seasonal Affective Disorder
Post-partum Hospital Stays Mandate
Powered Exoskeleton for Ambulation in Patients with Lower-Limb Disabilities
Prescription Digital Therapeutics for Substance Abuse
Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia
Prostate Specific Antigen (PSA) Screening/Testing Mandate
Prostate Specific Antigen (PSA) Screening/Testing Mandate - Effective 1.1.2022
Prostatic Stent - Temporary
Prostatic Urethral Lift
Pulsed Radiofrequency for the Treatment of Chronic Pain
Payment Adjustments for Serious Reportable Events (also known as SRE or Never Events) and Hospital Acquired Conditions
Payments for Outpatient Service Performed when a Member is Admitted as an Inpatient to a Different Hospital
Pharmacy Prescription Early Refill
Phototherapeutic Keratectomy
Phototherapy in the Home for the Treatment of Dermatological Conditions
Physical and Occupational Therapy
Physical and Occupational Therapy Payment Cap
Physician Concierge Services
Post Payment Audits
Preventive Medicine and Other Evaluation and Management Office/Outpatient Services
Preventive Services for Commercial Members
Preventive Services for Medicare Advantage Plans 2021
Professional Reporting Requirements for Services Not Personally Performed (AKA Incident to Services)
Prolonged Physician Services
Provider Credentialing and Recredentialing Process
Provider Guidelines for Requesting Point of Service Payment and Maintaining Patient Credit Card Information
Provider Reimbursement for Care Plan Management
Psychological and Neuropsychological Testing
Autorización previa
PathFinderTG® Molecular Testing
Pediatric Dental Services Essential Health Benefit -Dental Review
Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
Percutaneous Tibial Nerve Stimulation
Prior Authorization of Cardiology and Radiology Services
Prior Authorization of Drugs
Prior Authorization via Web-Based Tool for Durable Medical Equipment (DME)
Prior Authorization via Web-Based Tool for Procedures
Private Duty Nursing
Progesterone Therapy as a Technique to Reduce Preterm Birth in High-Risk Pregnancies
Proprietary Laboratory Analyses (PLA)
Proteogenomic Testing for Patients with Cancer
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