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Clinical Policy: Aquatic Therapy

WEBAquatic therapy is an active therapeutic intervention that takes place in water. The aquatic environment provides buoyancy, increased resistance (e.g., viscosity) and warmth. The …

Actived: 1 days ago

URL: https://www.policies-wellcare.com/content/dam/centene/OhanaHealthPlan/Medicaid/Policies/ClinicalPolicies/HI.CP.MP.500.pdf

Clinical Policy: Acupuncture

WEBAcupuncture is a form of complementary and alternative medicine (CAM) and one of the oldest medical procedures in the world.1 It encompasses a large array of styles and …

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Clinical Policy: Sterilization Procedures

WEBTubal Sterilization Procedure. Female sterilization, also called tubal occlusion or ligation, is a permanent contraceptive method. for beneficiaries who do not want to become …

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WNC.CP.117 Outpatient Behavioral Health Services Provided …

WEBDescription1. Outpatient behavioral health services are psychiatric and comprehensive clinical assessment, medication management, individual, group, and family therapies, …

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WNC.CP.108 Physical Rehabilitation Equipment and Supplies …

WEBThe plan may place appropriate limits, based on medical necessity criteria, on Durable Medical Equipment and Medical Supplies. When the prescribing Physician, …

Category: Medical Go Health

WNC.CP.193 Telehealth Virtual Communications and Remote …

WEBPolicy/Criteria1. I. WellCare of North Carolina® shall cover services delivered via telehealth, virtual communications, and remote patient monitoring services when the all the …

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WNC.CP.109 Research Based Behavioral Health Treatment (RB …

WEB4. the Research-Based Behavioral Health Treatment being requested has clinical efficacy in treating ASD; 5. based on the current or Psychological or adaptive or …

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Clinical Policy: Respite Services

WEBIt is the policy of Ohana Health Plan that respite services are medically necessary when all of the following criteria are met:1. Member is unable to care for themselves; Rationale …

Category: Medical Go Health

Clinical Policy: Nutritional Counseling

WEBThe Hawaii Department of Health outlines the benefits of individuals consulting with a licensed dietitian/nutritionist (LDN) or nutrition counselor (LNC): Prevention and …

Category: Nutrition Go Health

Clinical Policy: Ambulance Services

WEBIt is the policy of ®WellCare of North Carolina that ambulance transport is a covered benefit as follows: A. Air Medical Ambulance. 1. The point of origin is the …

Category: Medical Go Health

Clinical Policy: Physician’s Drug Program

WEBPolicy/Criteria1. I. It is the policy of WellCare of North Carolina® that Physician Administered Drugs are medically necessary for the following indications, as …

Category: Medical Go Health

Clinical Policy: Treatment for Peripheral Lymphedema

WEBThe patient's diagnosis and prognosis; Symptoms and objective findings, including measurements which establish the severity of the condition; The reason the device is …

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Clinical Policy: Air Ambulance

WEBThere are two categories of air ambulance services: fixed wing (airplane) and rotary wing (helicopter) aircraft. Fixed wing (FW) or rotary wing (RW) air ambulance are furnished …

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WNC.CP.210 Dietary Evaluation and Counseling and Medical …

WEBDescription1. Dietary Evaluation and Counseling offers direction and guidance for specific nutrient needs related to a beneficiary’s diagnosis and treatment. Individualized care …

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Clinical Policy: Routine Eye Examination and Visual Aids for

WEBDescription1. This policy describes the medical necessity of routine eye examination and visual aids for beneficiaries under the age of 21. Information regarding …

Category: Medical Go Health

WNC.CP.224 Home Infusion Therapy R

WEBThe beneficiary must be under the care of the referring physician. C. Drug Therapies. 1. The treatment is self-administered. 2. The beneficiary’s medical condition …

Category: Medical Go Health

WNC.CP.256 Medically Necessary Circumcision R

WEBDescription1. Male circumcision is the surgical removal of the foreskin (prepuce), which is the layer of skin covering the head (glans) of the penis. The foreskin …

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WNC.CP.209 State Plan Personal Care Services R

WEBDescription1. State Plan Personal Care Services (PCS) provide Personal Care Services in the beneficiary’s living arrangement by paraprofessional aides employed by licensed …

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