Bcbs Federal Medical Policy

February 21, 2021

Bcbs Federal Medical Policy

Medical decisions relative to medical technologies are to be made strictly by memberspatients in consultation with their health care. Medicare products Medicaid products and some self-insured plans may have additional policies and prior authorization requirements.

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Additional sources are used and can be provided upon request.

Bcbs federal medical policy. Medical Policy and Pre-certificationPre-authorization Information for Out-of-Area Members To view the out-of-area Blue Plans medical policy or general pre-certificationpre-authorization information please select the type of information requested enter the first three letters of the members identification number on the Blue Cross Blue Shield ID card and click GO. Information in Other Languages. Effective April 28 2021 medical drug policies will begin to move from this page to the Prior Review and Limitations page.

Its also why if you compare the list of professional medical policies to the list for institutional providers there could be a difference. Medical policies and clinical utilization management UM guidelines are two resources that help us determine if a procedure is medically necessary. Our medical policies help us determine what technology procedure treatment supply equipment drug or other service well cover.

The Blue Cross and Blue Shield Association does not intend by the FEP Medical Policy Manual or by any particular medical policy to recommend advocate encourage or discourage any particular medical technologies. View Medical Policies BCBSTX Clinical Payment and Coding Policies are based on criteria developed by specialized professional societies national guidelines eg Milliman Care Guidelines and the CMS Provider Reimbursement Manual. These Medical Policies serve as guidelines for health care benefit coverage decisions which may vary according to the different products and benefit plans offered by BCBSIL.

In addition to the active and pending Medical Policies BCBSIL has included policies which are under development or being revised. Transcutaneous Electrical Nerve Stimulation. 15 2020 PRNewswire -- Today the Blue Cross and Blue Shield Federal Employee Program FEP announced 2021 benefits including newly expanded telemedicine benefits along with a new tool to help provide greater cost transparency for members.

Blue365 - Discounts deals on gym memberships fitness gear healthy eating options more. Benefit plans vary in coverage and some plans may not provide coverage for certain services noted in the medical policies. Click here to view the Blue Cross Blue Shield Federal Employee Program FEP Medical Policy Updates September 2018 BCBS Federal Employee Program FEP Medical Policy Updates.

BCBSMS utilizes Medical Policy adopted by our Medical Policy Advisory Committee MPAC which is supported by the Blue Cross and Blue Shield Association Medical Policy research and development. Learn more about our non-discrimination policy and no-cost services available to you. Artificial Pancreas Device Systems.

Affected policies will remain in both locations temporarily but will be primarily located on the Prior Review and Limitations page once the review of all medical drugs has been transitioned to the new process. Medical Policies are the property of BCBSMS and any use of Medical Policy not agreed to by BCBSMS is strictly prohibited. The online Medical Policy Reference Manual contains approved medical policies and operating procedures for all products offered by CareFirst.

Cooling Devices Used in the Outpatient Setting. A BCBSKS medical policy may apply to professional providers to institutional providers or to both. Talk to a nurse or advisor - do you have questions about your health.

Medical policies are used by all plans and lines of business unless Federal or State lawas well as contract language including definitions and specific contract provisions or exclusionstake precedence over a medical policy. Medical policies are scientific documents that define the technologies procedures and treatments that are considered medically necessary not medically necessary and investigational link to investigational policy. Baby Yourself - free gifts and a personal nurse offer support for a healthy pregnancy.

Medical policies apply generally to all Blue Cross and Blue Plus plans and products. Silver Sneakers - where seniors have free access to nearly 200 fitness centers. Medical Policies Clinical UM Guidelines There are several factors that impact whether a service or procedure is covered under a members benefit plan.

The policies contained in the FEP Medical Policy Manual are developed to assist in administering contractual benefits and do not constitute medical advice. Noncontact Ultrasound Treatment for Wounds. Life at Blue Cross NC.

Thats why the medical policy format shows separate effective dates for professional and institutional providers. Medical policies which are based on the most current research available at the time of policy development state whether a medical technology procedure drug or device is. Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race color national origin sex age or disability in its health programs and activities.

Medical Policies Medical Coverage Guidelines We strive to cover procedures treatments devices and drugs proven to be safe and effective for a particular disease or condition and continually look at new medical advances and technology to determine for coverage and payment purposes if any is superior to those already in use. They are not intended to replace or substitute for the independent medical judgment of a practitioner or other health care professional in the treatment of an individual member. Additionally FEP will keep the rates the same in 2021 for its newest product FEP Blue Focus as well as for Blue Cross.

Click here to view the Blue Cross Blue Shield Federal Employee Program FEP Medical Policy Updates April 2018 Medical Policy Updates.

Blue Cross And Blue Shield S Federal Employee Program