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 | Policy Bulletin User Information
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| Policy Bulletin Disclaimers | |
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| The Policy Bulletin documents contain disclaimers specific to that particular type of bulletin.
The Medical Policy Bulletin Disclaimer
The Company makes decisions on coverage based on Policy Bulletins, benefit plan documents, and the member’s medical history and condition. Benefits may vary based on contract, and individual member benefits must be verified. The Company determines medical necessity only if the benefit exists and no contract exclusions are applicable.
This Medical Policy Bulletin document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy Bulletin will be reviewed regularly and be updated as scientific and medical literature becomes available. For more information on how Medical Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site.
The Claim Payment Policy Bulletin Disclaimer
Application of Claim Payment Policy is determined by benefits and contracts. Benefits may vary based on product line, group or contract. Medical necessity determination applies only if the benefit existsand no contract exclusions are applicable. Individual member benefits must be verified.
In products where members are able to self-refer to providers for care and services, members are advised to use participating providers in order to receive the highest level of benefits.
For more information on how Claim Payment Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site
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