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For Health Professionals

Medical Policy

Developing medical policy guidelines to help you.

Our dedicated medical policy unit is staffed by health care clinicians and other professionals who work closely with our medical directors and specialty provider panels to develop medical policy guidelines that reflect the medical necessity and appropriateness of medical care and services.

We take a proactive approach to the development and cyclical review of medical policy through continuous monitoring of regulatory agencies, current medical literature, national best practice standards, prevailing local standards of practice, and a variety of other resources. The daily interaction between our medical directors and participating providers allows us to be familiar with the concerns and issues within our provider community.