Healthy Blue Utilization Management

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Healthy Blue Utilization Management (UM) Program …

(Just Now) WebThis document outlines the utilization management (UM) program for Healthy Blue Medicaid plan members in North Carolina. It covers the scope, goals, objectives, structure, criteria, processes, and evaluation of the UM program.

https://www.healthybluenc.com/north-carolina/ncnc_caid_utilizationmgmtpolicy.pdf

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Clinical Utilization Management Guidelines

(2 days ago) WebThe new Clinical Utilization Management (UM) Guidelines below were adopted by the medical operations committee for Healthy Blue members on December 15, 2022. To …

https://provider.healthybluesc.com/docs/gpp/SCHB_CAID_Nov22CUMG.pdf?v=202308171411

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Healthy Blue Utilization Management (UM) Program Description …

(4 days ago) WebPage topic: "Healthy Blue Utilization Management (UM) Program Description 2021 - Review Date: March 31, 2021". Created by: Wendy Harper. Language: english. Toggle …

https://www.readkong.com/page/healthy-blue-utilization-management-um-program-8128150

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Medical Management Model Healthy Blue

(2 days ago) WebUtilization Management. Our Utilization Management (UM) program uses an integrated medical management model based on the physical, behavioral and social needs of …

https://provider.healthybluela.com/louisiana-provider/resources/medical-management

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June 2023 Utilization Management Clinical Criteria

(1 days ago) WebUtilization Management Clinical Criteria The Clinical Criteria below were adopted by the Medical Operations Committee at Blue Cross and Blue Shield of North Carolina for …

https://provider.healthybluenc.com/docs/gpp/NC_CAID_ClinicalCriteriaList.pdf?v=202206301515

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Utilization Management Clinical Criteria

(Just Now) WebNote: AIM Specialty Health is an independent company providing utilization management services for Healthy Blue providers on behalf of Blue Cross and Blue Shield of North …

https://provider.healthybluenc.com/docs/gpp/NC_CAID_Aug22CUMG.pdf?v=202303101711

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Healthy Blue + Medicare HMO D-SNP Providers Blue Cross NC

(1 days ago) WebCase management (medical & drug) Phone: 866-611-4287. Fax: 855-443-7821. Healthy Blue + Medicare. 3350 Peachtree Road NE. Atlanta, GA 30326. View our Healthy Blue …

https://www.bluecrossnc.com/providers/networks-programs/blue-medicare/healthy-blue-medicare

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Search Medical Policies And Clinical Guidelines Healthy Blue

(3 days ago) WebThe Clinical Utilization Management (UM) Guidelines published on this website are not always used by all plans or lines of business. Clinical UM Guidelines are available for …

https://provider.healthybluene.com/nebraska-provider/medical-policies-and-clinical-guidelines

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Clinical Utilization Management Guidelines - Healthy Blue Ne

(6 days ago) WebBlue Cross and Blue Shield Association. BNEPEC-0003-20 September 2020 State approval: 09/03/2020 Clinical Utilization Management Guidelines The new Clinical …

https://provider.healthybluene.com/docs/gpp/NENE_CAID_ClinicalUtilizationMgmtGuidelines.pdf?v=202012182149

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Contact Us Healthy Blue Louisiana

(4 days ago) WebPrior Authorizations — Utilization Management Phone: 1-800-262-2731. Fax: 1-877-423-9972. Case Management. Phone: 1-833-607-6516. Healthy Blue is the trade name …

https://provider.healthybluela.com/louisiana-provider/contact-us

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Utilization management Clinical Criteria - Healthy Blue Louisiana

(1 days ago) WebHealthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross Blue Shield Association. LAHB-CD-032876-23 …

https://provider.healthybluela.com/docs/gpp/LALA_CAID_MedicalPoliciesClinicalUtilizationMgmt.pdf?v=202105041815

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Clinical Utilization Management Guidelines - Healthy Blue Ne

(4 days ago) WebHealthy Blue is the trade name of Community Care Health Plan of Nebraska, Inc., an independent licensee of the Blue Cross and Blue Shield Association. BNEPEC-0569-21 …

https://provider.healthybluene.com/docs/gpp/NE_CAID_FebClinicalUMGuidelines.pdf?v=202110061701

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May 2023 Utilization Management Clinical Criteria

(7 days ago) WebUtilization Management Clinical Criteria . The Clinical Criteria below, indicated as new or revised, was adopted by the Medical Operations Committee for Healthy Blue members …

https://provider.healthybluenc.com/docs/gpp/NCNC_CAID_November2022CUMGBulletin.pdf?v=202306071900

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Prior Authorization Healthy Blue of South Carolina

(9 days ago) WebSometimes we ask other companies that are not part of Healthy Blue to help us decide if care is proper. Some examples are those who are experts in the use of X-rays and other …

https://www.healthybluesc.com/prior-authorization

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Horizon Blue Cross Blue Shield of New Jersey 2018 Managed …

(5 days ago) Weband Authorization and select Utilization Management Requests. You may also call 1-800-664-BLUE (2583). Preventive and Well Care There is no member cost sharing for …

https://www.horizonblue.com/sites/default/files/2018-01/Benefit_Grid_MC.pdf

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Horizon Blue Cross Blue Shield of New Jersey 2017 Managed …

(4 days ago) Weband Authorization and select Utilization Management Requests. You may also call 1-800-664-BLUE (2583). Horizon Blue Cross Blue Shield of New Jersey 2017 Managed …

https://www.horizonblue.com/sites/default/files/2017-04/2017_Managed_Care_Benefits_at_a_Glance_Reference_Guide.pdf

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Medical Management Model Healthy Blue

(1 days ago) WebUtilization Management. Our Utilization Management (UM) program uses an integrated medical management model based on the physical, behavioral, and social needs of …

https://provider.healthybluene.com/nebraska-provider/resources/medical-management

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Chiropractic & Physical Medicine Services Program Frequently …

(6 days ago) Webwith ASH, integrates evidence-based utilization management guidelines with clinical best practices, specialized peer-to-peer engagement, claims review and management, and …

https://www.horizonblue.com/sites/default/files/2019-07/ASH_External_FAQ.pdf

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Health Care Utilization Following Interventions to Improve Social …

(8 days ago) WebThe reduction in inpatient and emergency care utilization could be due to an instrumental support system that may have prevented a health condition from …

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2806587

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Utilization Management Request Tool - Horizon BCBSNJ

(1 days ago) WebThe chart below provides a detailed crosswalk for corresponding revenue codes and HCPCS codes when obtaining home health service authorizations through Horizon …

https://www.horizonblue.com/sites/default/files/2016-12/hhc_revcode_crosswalk.pdf

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