Asuris Policies
Asuris Medical Policies are developed to provide guidance for members and
providers regarding coverage in accordance with contract terms. Benefit determinations
are based in all cases on the applicable contract language. To the extent there
may be any conflict between the Medical Policy and contract language, the contract
language takes precedence.
Newly established or revised medical, reimbursement and administrative policies
and information on quality improvement activities may be communicated in our
newsletter, The
Connection OnlineSM,
or by letter. It is important that physicians, other health care professionals,
facilities and their staff review each issue to keep abreast of these policies.
For more information about specific policies, select the appropriate manual:
| Medical and Reimbursement Policy
Manuals |
Description |
| Medical Policy |
The purpose of medical policy is to provide guidelines
for determining coverage criteria for specific procedures, equipment
and services. The Introduction section of this manual includes information
about:
- Selecting Technologies
- Research Sources
- Technology Assessment
- Approval process
NOTE: Asuris Medical Policy does not apply to Medicare
and Asuris TruAdvantage™. Review the Medicare
Advantage Plans (PDF) section for more information.
Your patients may ask questions regarding Asuris Medical Policy, as our
policies are also available to our members on www.asuris.com |
| Behavioral Health Policy |
These policies are developed using evidence-based treatment
guidelines as well as clinical best practices/standards of care. They are
consistent with Milliman, SAMHSA and culturally competent practice philosophy
and standards. |
Reimbursement Policy |
These policies document Asuris payment policy
and correct coding for medical and surgical services and supplies.
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