The Medical Policies listed below are examples provided for informational purposes only.
These Medical Policies do not constitute medical advice. When deciding coverage, the terms of the enrollee’s plan and any applicable laws are referenced.
Plan terms are found in plan documents, including but not limited to Certificates of Coverage, Benefit Riders, and Summary Plan Descriptions.
The terms of an enrollee’s plan may differ from these Medical Policies. In the event of a conflict, the terms of the enrollee’s plan supersede the Medical Policy.
The list below is not a comprehensive list of Medical Policies. More recent versions of the Medical Policies, additional Medical Policies, InterQual® criteria, and Coverage Determination Guidelines may also apply.