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Clinical guidelines and policy bulletins

Guidelines

We’ve chosen certain clinical guidelines to help our providers get members high-quality, consistent care that uses services and resources effectively. These include treatment protocols for specific conditions, as well as preventive health measures.

These guidelines are intended to clarify standards and expectations. They should not: 

 

  • Take precedence over your responsibility to provide treatment based on the member’s individual needs
  • Substitute as orders for treatment of a member
  • Guarantee coverage or payment for the type or level of care proposed or provided

Also of interest: