Medical Payment Policies
The purpose of UHA Medical Payment Policies is to guide coverage decisions and to provide information regarding the need for prior authorization and other administrative directives. They are not intended to influence treatment decisions and do not constitute plan authorization. Medical necessity must be clear. They are not explanations of benefits.
Medical policies can be highly technical and complex and are provided here for informational purposes. They do not constitute medical advice. Medical technology is constantly evolving and these medical policies are subject to change without notice. Additional medical policies may also be developed from time to time and some may be withdrawn from use as science advances. Clinical context can be highly variable.
- Advanced Practice Registered Nurse/Physician Assistant (APRN/PA)
- Ambulatory Surgery Centers (ASCs)
- Anesthesia for Dental Services
- Anesthesia Services for Gastrointestinal Endoscopic Procedures
- Applied Behavior Analysis for Autism Spectrum Disorders
- Artificial Insemination/Intrauterine Insemination (IUI)
- Cardiac Ablation Procedures
- Cardiovascular Disease Risk Assessment and Management Using Novel Biomarkers
- Cellulitis and Chronic/Complex Wound Care
- Chronic Opioid Therapy
- Clinical Trials
- Colorectal Cancer Screening Payment Policy
- Complementary and Alternative Medicine
- Conscious Sedation
- Continuity of Care
- Continuous Glucose Monitoring of Interstitial Fluid
- Cosmetic and Reconstructive Surgery and Services
- COVID-19 Serology (IgG or IgM) Testing
- COVID-19 Diagnostic Testing
- Panniculectomy/Abdominoplasty
- Physical Therapy
- Preventive Health Guidelines: Newborn and Children
- Preventive Health Guidelines: Men
- Preventive Health Guidelines: Prenatal Care
- Preventive Health Guidelines: Women
- Prophylactic Mastectomy
- Prostate Cancer Treatment
- Psychological and Neuropsychological Testing
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