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      Clinical Guidance and Policies

        • Acupuncture (PDF)
        • Cosmetic & Reconstructive Surgery (PDF)
        • Fertility Preservation (PDF)
        • Gender Dysphoria Services & Surgery (PDF)
        • Genetic Testing for Health Plan Members (PDF)
        • Habilitative Services (PDF)
        • Investigational and Experimental Treatment (PDF)
        • Preimplantation Genetic Testing (PDF)
        • Chronic Fatigue Syndrome (PDF)
        • Dermatology (PDF)
        • Loop Recorder (PDF)
        • Pain Management (PDF)
        • Ambulatory Heart Failure Guideline (PDF)
          • Heart Failure Referral - I NEED HELP (PDF)
        • Adult Back Pain Guideline (PDF)
        • Adult Neck Pain Guideline (PDF)
        • Heart Failure (PDF)
        • Back and Neck Pain (PDF)

      Disclaimer

      The policies on this page are provided for informational purposes and involves guidelines for coverage decisions and medical necessity. They do not establish health plan authorization or confirm coverage availability. Policies do not constitute medical advice or medical care and are not intended to replace medical judgment for treatment of individuals.

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