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Clinical Resources

Clinical Criteria & Guidelines
Clinical Criteria Overview
Learn how we review authorization requests
InterQual Criteria
Learn about InterQual® criteria
Medical Policies
Access medical policies on clinical and pharmacy topics

Prior Authorization
Prior Auth Overview
Learn about prior authorization requirements and resources
Cancer Care
Learn more about our authorization program for outpatient medical oncology and radiation oncology
Chiropractic Services
Find information on the chiropractic services authorization program
Dental
Learn about prior authorization for dental services
Genetic Testing
Learn about authorization requirements for genetic testing
High-tech Radiology
Access resources and information for high-technology radiology services
Home Health Care
Get information on authorizations for home health care services
Outpatient Rehabilitation Therapy
Find out about PT, OT, and speech therapy services and authorization requirements
Sleep Management
Learn what to do to refer members for sleep management services

Clinical Programs & Information
Health Management Programs
Get information on case management and chronic condition management programs that we offer
Mental Health
Access information specific to mental health providers and services
Oral & Overall Health
Make the connection between oral & overall health
Treatment Resources
Access information, clinical guidelines, and other resources to care for your patients
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