Policy Name Effective Date Revision Date Next Review Date
A
admin-023 Administrative Denials September 01, 2021 May 26, 2021 May 26, 2022
D
admin-021 Dismissal: Failure to Follow Filing Procedures July 1, 2021 May 26, 2021 May 26, 2022
mp-026 Drug Levels and Antibody Testing for Infliximab, Adalimumab, Vedolizumab and Ustekinumab September 20, 2021 July 15, 2021 July 15, 2022
reimb-030 Durable Medical Equipment (DME) October 06, 2021 August 06, 2021 August 06, 2022
G
mp-045 General Policy for Genetic Testing August 23, 2021 June 23, 2021 June 23, 2022
I
MP-068 Intraosseous Basivertebral Nerve Ablation Procedure (Intracept) August 23, 2021 June 23, 2021 June 23, 2022
M
reimb-034 Multiple Procedure Payment Reduction (MPPR) September 01, 2021 July 01, 2021 July 01, 2022
N
reimb-007 Next Generation Sequencing (NGS) Genetic Testing October 06, 2021 August 6, 2021 August 06, 2022
P
reimb-026 Prolonged Services September 01, 2021 May 19, 2021 May 19, 2022
R
admin-022 Retrospective Service Reviews September 01, 2021 May 26, 2021 May 26, 2022