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Medical and Claim Payment Policy Library

Our Medical Policy and Claim Payment departments define medical necessity criteria and coverage positions on topics such as medical services, procedures, DME, therapies, drugs, etc., and provide the reimbursement rules and billing guidelines for timely and appropriate payment.

All policy documents are considered complimentary to the HPP Provider Manual.

Library

Policy Library

Policy Name

Summary

Effective Date

Revision Date

RB.001.A

Ambulance Ground Mileage Claim

Documents our reimbursement rules for ambulance ground mileage and ambulance services

10/1/2015

N/A

BN.001.B

Cosmetic Surgery

Documents our coverage position for Cosmetic Services.

10/1/2007

8/1/2016

BN.001.B

STAT Labs

Provides reporting requirements and reimbursement rules for STAT laboratory tests (aka, labs)

7/1/2016

N/A

Please note: The effective date of select policies found in the Policy Library above may considerably pre-date the actual date of their availability on this Policy Library web page. This is because the Policy Library will include PDFs of policies that have been in effect for many years, but have not been previously published on our website. 

Note: New and updated policies will typically be published in the Policy Library 30 to 60 days prior to their implementation date, ensuring that your office is given appropriate notification of changes and updates that may affect your office.

 

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