Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). See all legal notices For language services, please call the number on your member ID card and request an operator. Why Is NCQA Accreditation Important? - Wellsource endstream endobj 69 0 obj <>/Size 45/Type/XRef>>stream And for good reason if it were easy, just anyone could do it. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Notification to Authorities and Practitioner Appeal Rights. Kristine Toppe - Assistant Vice President of State Affairs at Ncqa - Wiza Do you want to continue? No fee schedules, basic unit, relative values or related listings are included in CPT. Copyright 2023 National Committee for Quality Assurance. Update educational materials and articles on the provider website to ensure that information is accurate. We have developed strict policies and procedures to protect member information including race, ethnicity and language preference information from inappropriate use and disclosure. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. ,) V-Wz/"HESru66x k#1:1eM8Q g`$d(d|jJ\]7CY]h:tUf5u{;=== fJ*F=(W3OiLz}mLT EN"TPrr5[U1 UEpQ_(!`9%1pcrYfgNrLB,e~'usgg=E@gIU wFGfMK_* T@F2w\0t~Xx[J4pKqa}o* ]xqx03P^=NcjdU1al7%D2y'AL,,UB,b6 trailer /Size 49 /Info 8 0 R /Root 10 0 R /Prev 21523 /ID[060e888545013965100abd54e3afe5c1>060e888545013965100abd54e3afe5c1>] >> startxref 0 %%EOF 10 0 obj /Type . 0000002555 00000 n (The industry standard is 10 to 20%.). NCQA Recognizes WI UnitedHealthcare Plan for Health Equity Efforts xref How do I credential with UnitedHealthcare? Use the report cards to find health plans, practices, clinicians or other partners that meet NCQA standards and can help you drive improvement, keep people healthy and reduce health care costs. 0000001935 00000 n Contact us at My.NCQA to ask about licensing the ratings data for research or display. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Health Insurance Providers Texas
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