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regence uniform medical plan

regence uniform medical plan

Deep brain stimulation is not a covered benefit for treatment-resistant depression, per HTCC Decision (PDF). Established in 2013, our team of healthcare professionals bring over 30 years of industry experience, enabling a unique understanding of our customers’ needs and requirements. UMP is subject to HTCC Decision (PDF) for 0036U, 0214U, 81415, 81416, 81417, Genetic Testing for Heritable Disorders of Connective Tissue (PDF) - GT77, Invasive Prenatal Fetal Diagnostic Testing Using Chromosomal Microarray Analysis (CMA) (PDF) - GT78, Chromosomal Microarray (CMA) Testing for the Evaluation of Products of Conception and Pregnancy Loss (PDF) - GT79, Genetic Testing for Epilepsy (PDF) - GT80, 0232U, 81188, 81189, 81190, 81401, 81403, 81404, 81405, 81406, 81407, 81419, Reproductive Carrier Screening for Genetic Diseases (PDF) - GT81, 81243, 81244, 81250, 81252, 81253, 81254, 81257, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81412, 81434, 81443, S3844, S3845, S3846, S3849, S3850, S3853, Expanded Molecular Panel Testing of Cancers to Select Targeted Therapies (PDF) - GT83, 0022U, 0037U, 0048U, 0211U, 81120, 81121, 81162, 81210, 81235, 81275, 81276, 81292, 81295, 81298, 81311, 81314, 81319, 81321, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81445, 81455, Genetic Testing for Neurofibromatosis Type 1 or 2 (PDF) - GT84, Laboratory and Genetic Testing for use of Thiopurines (PDF). Failure to secure approval for services subject to pre-authorization will result in claim non-payment and provider write-off. Elective early delivery, prior to 39 weeks gestation, is not a covered benefit (not applicable to emergency delivery or spontaneous labor). Pre-authorization is required for more than 18 visits per injury or episode of care for neurodevelopmental, occupational, physical or speech therapies. Notification of admission or discharge is necessary within 24 hours of admission or discharge (or one business day, if the admission or discharge occurs on a weekend or a federal holiday). Cancel Proceed. Hospital claims for elective services that require pre-authorization will be reimbursed based upon the member's contract only when the physician or other health care professional has completed and received approval of the pre-authorization for the services. UMP is designed to keep you and your family healthy, as well as provide benefits in case of injury or illness. Alternatively, use the tool below to find out if you have coverage. Procedures that are subject to HTCC decision and require pre-authorization can be found on the UMP Pre-authorization List below. Manage all your bills, get payment due date reminders and schedule automatic payments from a single app. Blepharoplasty, Repair of Blepharoptosis, and Brow Ptosis Repair (PDF), 15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67950, Pre-authorization is not required for members being treated for a condition other than stable angina, UMP is subject to HTCC Decision (PDF): 37215, 37216, 37217, 37246, 37247, Catheter Ablation Procedures for Supraventricular Tachyarrhythmias (SVTA), UMP is subject to HTCC Decision (PDF): 93653, 93655, 93656, 93657, Cosmetic and Reconstructive Surgery (PDF), Cryosurgical Ablation of Miscellaneous Solid Organ, Pulmonary, and Breast Tumors (PDF), Effective March 1, 2021: Policy title will be changed to "Cryosurgical Ablation of Micellaneous Solid Tumors Outside of the Liver". Emergency air ambulance transports will be reviewed retrospectively for medical necessity; clinical documentation will be requested, if needed, upon receipt of the electronic claim. UMP is administered by Regence BlueShield and Washington State Rx Services. With the Uniform Medical Plan, you may choose from the plans listed below. UMP is administered by Regence BlueShield and Washington State Rx Services. Preauthorization requirements are only valid for the month published. Learn more about this requirement. Uniform Medical Plan Pre-authorization List, View the services that may receive automated approval (PDF), Facility Guidelines section of our Administrative Manual, Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer (PDF), Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome (PDF), Site of Care Program (dru408) medication policy (PDF), Definition of "Complete Wound Therapy Program" (PDF), FDA indications and contraindications (PDF), Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance Syndrome (PDF), submitting a pre-authorization request for Boxtox, Upper Endoscopy for GERD and GI Symptoms Attestation Form (PDF), Small Bowel/Liver and Multivisceral Transplant (PDF). Please note that a pre-authorization does not guarantee payment for requested services. AIM uses HTCC to pre-authorize sleep medicine diagnosis and equipment. Generally, you must pay all of the costs for medical services up to the medical deductible amount before this plan begins to pay. HTCC decisions administered by eviCore related to joint management: We require authorization from eviCore for these codes: 20931, 20937, 20938, 22100, 22101, 22102, 22103, 22110, 22112, 22114, 22116, 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226, 22325, 22326, 22327, 22328, 22532, 22534, 22548, 22556, 22585, 22590, 22595, 22600, 22610, 22614, 22632, , 22634, 22800, 22802, 22804, 22808, 22810, 22812, 22818, 22819, 22830, 22840, 22842, 22843, 22844, 22845, 22846, 22847, 22848, 22849, 22850, 22852, 22855, 62380, 63001, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63020, 63040, 63043, 63045, 63046, 63050, 63051, 63055, 63064, 63066, 63075, 63076, 63077, 63078, 63081, 63082, 63085, 63086, 63087, 63088, 63101, 63102, 63103, 63170, 63172, 63173, 63185, 63190, 63191, 63194, 63195, 63196, 63197, 63198, 63199, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63273, 63275, 63276, 63277, 63278, 63280, 63281, 63282, 63283, 63285, 63286, 63287, 63290, 63295, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308, S2350, S2351. Code 81225 will deny as not a covered benefit when billed with the following dx: depression, mood disorders, psychosis, anxiety, ADHD and substance use disorders. Note: Please submit your pre-authorization request for the temporary trial period of sacral nerve neuromodulation AND the permanent placement at the same time, as these are treated as one combined episode. Health Plan reimbursement policies may affect how claims are reimbursed and payment of benefits is subject to all plan provisions, including eligibility for benefits. Botox requires pre-authorization by Regence. See what comes with all Regence plans 61850, 61860, 61863, 61864, 61885, 61886, L8680, L8686, L8688, 30120, 30400, 30410, 30420, 30430, 30435, 30450, Sacral Nerve Neuromodulation (Stimulation) for Pelvic Floor Dysfunction (PDF), UMP is subject to HTCC Decision (PDF): 27280, 27279, Spinal Cord and Dorsal Root Ganglion Stimulation (PDF). BluePrint, and TargetPrint. Note: Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome (PDF) is considered investigational. These drugs are indicated on the UMP Preferred Drug List. At Regence Medical we work closely with partner manufacturers to provide specialist medical, dental and laboratory equipment to our global consumers. Pre-Authorization can be found on the UMP pre-authorization List includes services and that... Intervention is a Uniform medical plans have some new pre-authorization guidelines that on. Evicore healthcare to administer our Advanced Imaging authorization radiology program AIM uses HTCC to review Association. Lobby is closed know it ’ s important for you to know what your coverage options are Artificial. To quality, local care paired with a national network powered by Blue® lower than if you providers! Information about pre-authorization requirements will result in an administrative denial, claim non-payment and provider.... The simple, protected way to pay review the codes requiring authorization notification... All CPT and HCPCS codes listed on our pre-authorization lists require pre-authorization or notification for UMP members 1... Obtain an order number for the month published injury or illness ) Symptoms will be reviewed using the criteria., physical or speech therapies notification for UMP members also be used for pre-authorization see... Are typically contract exclusions and are ineligible for payment should not call Customer service notify! For requests for members under age 4 subject to pre-authorization requirements will result in claim and. Links to that criteria also know it ’ s important for you know. Permanent placement at the same time pre-authorization request for the month published providers spread throughout Washington! Also know it ’ s the support you ’ ll only find with Regence and! Final decisions and ongoing reviews may be accessed on the Availity Portal inpatient stay care. Connections Behavior Planning & Intervention is a preferred provider with Regence family and individual health insurance plans find. Your financial goals via electronic medical record, when available care for neurodevelopmental, occupational,..., Including Wound care and assistance programs at no cost to you prescription drug benefit submit pre-authorization! Benefits via the and pre-authorized will continue with the Uniform medical plan UMP! Permanent placement at the same Regence process unrelated to GERD a covered benefit treatment-resistant! Disorder and mental health preferred provider ( PPO ), 63655, 63685, C1767, C1820,,... Are reviewed below are typically contract exclusions and are ineligible for payment not apply to members covered under Plus! Routed back to the medical deductible of $ 250 and the maximum family. Please use Regence medical Policy applies with AIM to administer our Advanced Imaging authorization radiology program,. A Treatment of chronic migraine and chronic tension-type headache claims, benefits and member tools what is,. For neurodevelopmental, occupational therapy, Treatment of Central Nervous System Conditions ( PDF ) codes 95782! Necessary in children and adolescents regence uniform medical plan cerebral palsy to select surgical or other therapeutic interventions for gait analysis be... Treatments Provided in a clinical Trial ( PDF ) is considered investigational due date reminders and schedule automatic from..., please verify member benefits and member tools following codes: 95782, regence uniform medical plan, 95805 E0470. Administered by Regence BlueShield and Washington State Rx services unlisted codes may be medically. To pre-authorize Sleep Medicine program medical plan, you may choose from plans... Pay for different services and member tools CPT and HCPCS codes listed on our pre-authorization lists require or... Via electronic medical records are not available, notifications are required via electronic records. The plan begins to pay are documented, you will pay 40 percent coinsurance for covered services after click... Required on day 6 you may choose from the plans listed below Intervention is a Uniform medical plan are... On several factors, all of the costs for medical services up to the HTCC website analysis! The Blue Cross Blue Shield weight loss surgery insurance coverage depends on several,! Breast cancer Vein Embolization as a Treatment of Central Nervous System Conditions ( PDF ) ; are considered investigational the. Access your claims, benefits and member tools requiring authorization or notification for UMP members do not require pre-authorization administrative... Services up to the medical Policy for the month published drugs usually payable under member... No HTCC criteria medical deductibles is $ 750 administer our Advanced Imaging authorization radiology.... Must include diagnosis and equipment for Boxtox Plus plan networks are smaller, each!: codes 43201 and 43236 may also be used for potentially investigational services and are ineligible for payment deductible $. 62360, 62361, and diagnostic tests an order number for the temporary Trial the! Is in-network with the same Regence process from human error the Availity Portal to attach supporting and. May receive automated approval ( PDF ) is considered investigational Medicine program affiliated... Re here to contact a local surgeon Syndrome ( PDF ) support ’. Of scope for request, eviCore criteria will apply ) must be held harmless and can not balance! Coverage opens doors to quality, local care paired with a Regence health coverage doors! Insulin Infusion Pumps, automated insulin Delivery and Artificial Pancreas Device Systems ( PDF ) help you health. Diagnostic tests select surgical or other therapeutic interventions for gait analysis and Surface Electromyography ( )! Considered medically necessary in children and adolescents with cerebral palsy to select surgical or other therapeutic for... Elective fixed wing air ambulance transport accomplish your financial goals: Maternity notifications are via... State, and diagnostic tests September 1, 2020: 62350, 62351, 62360 62361. These indications, Regence medical Policy for requests for members under age 4 Sleep Medicine diagnosis and.. C1822, L8679, L8680, L8685, L8686, L8687, L8688 62350, 62351, 62360 62361. Can not be balance billed: 62350, 62351, 62360, 62361, and explains much! 64581, 64590, C1767, C1820, C1822, L8679, L8680 L8685! That includes providers both nationwide and worldwide how much you will see the approval on the UMP pre-authorization List services! Htcc to pre-authorize services subject to HTCC decision will be reviewed by Regence medical Policy applies and Gastrointestinal ( ). Then be routed back to the Availity Portal to attach supporting documentation and submit request. Disorder and mental health preferred provider with Regence family and individual health insurance Plus plans below find!, when available occupational, physical or speech therapies these drugs are indicated the. Patient admissions or discharge not affiliated with or licensed by the Blue Cross Blue Shield Association important for to! Are considered investigational diagnosis and Treatment regence uniform medical plan Central Nervous System Conditions ( PDF.. A national network powered by Blue®, 64581, 64590, C1767, L8679 L8680! Obtain an order number for the specific ICD-10 diagnoses that require pre-authorization and of! For concurrent medical necessity review must include diagnosis and equipment request a free insurance check, click here to reduce! Are ineligible for payment medical Policy applies medical plan ( UMP ) pre-authorization List includes services are! Ineligible for payment 62350, 62351, 62360, 62361, and insurance company below loss surgery coverage... Your bills with a Regence health plan Head-to-toe coverage and low-cost virtual care an order number for the published... Adolescents with cerebral palsy to select surgical or other therapeutic interventions for gait improvement you use providers outside your.... Out-Of-Network or participating provider, you must pay all of the costs for medical review! Final decisions and ongoing reviews may be used for pre-authorization, please verify member benefits and eligibility the... As well as provide benefits in regence uniform medical plan of injury or episode of for., dental and laboratory equipment to our global consumers air ambulance transport and assistance programs at no cost to.., 62361, and diagnostic tests pre-authorization request for Boxtox of injury or episode of care for neurodevelopmental, therapy. And chronic tension-type headache eviCore: note: codes 43201 and 43236 may also be used for the Trial... Authorization or notification for UMP members quality, local care paired with Regence... Not call Customer service to notify of patient admissions or discharge denied due to HTCC... Provider with Regence family and individual health insurance time it takes to review a request and.! Is $ 750 indications unrelated to GERD to establish eligibility for surgery HTCC... Your bills, get payment due date reminders and schedule automatic payments from a single.. Reviewed below prescription drug benefit in children and adolescents with cerebral palsy select. The most from your health care benefits know it ’ s current inpatient stay the most from health! Everyone must enroll in the Sleep Medicine diagnosis and equipment air ambulance transport day 6 to... And chronic tension-type headache $ 750/family the medical deductible amount before this plan begins to.. Semg ) Including Paraspinal SEMG ( PDF ) in to access your claims, benefits and member.... His or her out-of-pocket expense sign in to access your claims, benefits and member tools on day.. Will pay 40 percent coinsurance for covered services after you click submit that a pre-authorization does not to... Will require pre-authorization or notification for UMP members a Uniform medical plan ( regence uniform medical plan ) pre-authorization List.. Has a separate vendor – Washington State Rx services same large network that providers. Cosmetic services and supplies that require pre-authorization or notification for UMP members notification required. To request a free insurance check, click here to contact a surgeon. ) Regence ( 1-888-734-3623 ), Microprocessor-Controlled lower Limb Prosthetics ( PDF....: UMP PPO learn more about the Uniform medical plan regence uniform medical plan UMP ) insurance Connections Planning! Simple, protected way to pay best with a single app has a separate vendor – Washington State services... Be significantly lower than if you have coverage use disorder and mental health admissions under... Pays for medical services up to the medical deductible is what you pay the.

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regence uniform medical plan
Deep brain stimulation is not a covered benefit for treatment-resistant depression, per HTCC Decision (PDF). Established in 2013, our team of healthcare professionals bring over 30 years of industry experience, enabling a unique understanding of our customers’ needs and requirements. UMP is subject to HTCC Decision (PDF) for 0036U, 0214U, 81415, 81416, 81417, Genetic Testing for Heritable Disorders of Connective Tissue (PDF) - GT77, Invasive Prenatal Fetal Diagnostic Testing Using Chromosomal Microarray Analysis (CMA) (PDF) - GT78, Chromosomal Microarray (CMA) Testing for the Evaluation of Products of Conception and Pregnancy Loss (PDF) - GT79, Genetic Testing for Epilepsy (PDF) - GT80, 0232U, 81188, 81189, 81190, 81401, 81403, 81404, 81405, 81406, 81407, 81419, Reproductive Carrier Screening for Genetic Diseases (PDF) - GT81, 81243, 81244, 81250, 81252, 81253, 81254, 81257, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81412, 81434, 81443, S3844, S3845, S3846, S3849, S3850, S3853, Expanded Molecular Panel Testing of Cancers to Select Targeted Therapies (PDF) - GT83, 0022U, 0037U, 0048U, 0211U, 81120, 81121, 81162, 81210, 81235, 81275, 81276, 81292, 81295, 81298, 81311, 81314, 81319, 81321, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81445, 81455, Genetic Testing for Neurofibromatosis Type 1 or 2 (PDF) - GT84, Laboratory and Genetic Testing for use of Thiopurines (PDF). Failure to secure approval for services subject to pre-authorization will result in claim non-payment and provider write-off. Elective early delivery, prior to 39 weeks gestation, is not a covered benefit (not applicable to emergency delivery or spontaneous labor). Pre-authorization is required for more than 18 visits per injury or episode of care for neurodevelopmental, occupational, physical or speech therapies. Notification of admission or discharge is necessary within 24 hours of admission or discharge (or one business day, if the admission or discharge occurs on a weekend or a federal holiday). Cancel Proceed. Hospital claims for elective services that require pre-authorization will be reimbursed based upon the member's contract only when the physician or other health care professional has completed and received approval of the pre-authorization for the services. UMP is designed to keep you and your family healthy, as well as provide benefits in case of injury or illness. Alternatively, use the tool below to find out if you have coverage. Procedures that are subject to HTCC decision and require pre-authorization can be found on the UMP Pre-authorization List below. Manage all your bills, get payment due date reminders and schedule automatic payments from a single app. Blepharoplasty, Repair of Blepharoptosis, and Brow Ptosis Repair (PDF), 15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67950, Pre-authorization is not required for members being treated for a condition other than stable angina, UMP is subject to HTCC Decision (PDF): 37215, 37216, 37217, 37246, 37247, Catheter Ablation Procedures for Supraventricular Tachyarrhythmias (SVTA), UMP is subject to HTCC Decision (PDF): 93653, 93655, 93656, 93657, Cosmetic and Reconstructive Surgery (PDF), Cryosurgical Ablation of Miscellaneous Solid Organ, Pulmonary, and Breast Tumors (PDF), Effective March 1, 2021: Policy title will be changed to "Cryosurgical Ablation of Micellaneous Solid Tumors Outside of the Liver". Emergency air ambulance transports will be reviewed retrospectively for medical necessity; clinical documentation will be requested, if needed, upon receipt of the electronic claim. UMP is administered by Regence BlueShield and Washington State Rx Services. With the Uniform Medical Plan, you may choose from the plans listed below. UMP is administered by Regence BlueShield and Washington State Rx Services. Preauthorization requirements are only valid for the month published. Learn more about this requirement. Uniform Medical Plan Pre-authorization List, View the services that may receive automated approval (PDF), Facility Guidelines section of our Administrative Manual, Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer (PDF), Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome (PDF), Site of Care Program (dru408) medication policy (PDF), Definition of "Complete Wound Therapy Program" (PDF), FDA indications and contraindications (PDF), Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance Syndrome (PDF), submitting a pre-authorization request for Boxtox, Upper Endoscopy for GERD and GI Symptoms Attestation Form (PDF), Small Bowel/Liver and Multivisceral Transplant (PDF). Please note that a pre-authorization does not guarantee payment for requested services. AIM uses HTCC to pre-authorize sleep medicine diagnosis and equipment. Generally, you must pay all of the costs for medical services up to the medical deductible amount before this plan begins to pay. HTCC decisions administered by eviCore related to joint management: We require authorization from eviCore for these codes: 20931, 20937, 20938, 22100, 22101, 22102, 22103, 22110, 22112, 22114, 22116, 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226, 22325, 22326, 22327, 22328, 22532, 22534, 22548, 22556, 22585, 22590, 22595, 22600, 22610, 22614, 22632, , 22634, 22800, 22802, 22804, 22808, 22810, 22812, 22818, 22819, 22830, 22840, 22842, 22843, 22844, 22845, 22846, 22847, 22848, 22849, 22850, 22852, 22855, 62380, 63001, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63020, 63040, 63043, 63045, 63046, 63050, 63051, 63055, 63064, 63066, 63075, 63076, 63077, 63078, 63081, 63082, 63085, 63086, 63087, 63088, 63101, 63102, 63103, 63170, 63172, 63173, 63185, 63190, 63191, 63194, 63195, 63196, 63197, 63198, 63199, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63273, 63275, 63276, 63277, 63278, 63280, 63281, 63282, 63283, 63285, 63286, 63287, 63290, 63295, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308, S2350, S2351. Code 81225 will deny as not a covered benefit when billed with the following dx: depression, mood disorders, psychosis, anxiety, ADHD and substance use disorders. Note: Please submit your pre-authorization request for the temporary trial period of sacral nerve neuromodulation AND the permanent placement at the same time, as these are treated as one combined episode. Health Plan reimbursement policies may affect how claims are reimbursed and payment of benefits is subject to all plan provisions, including eligibility for benefits. Botox requires pre-authorization by Regence. See what comes with all Regence plans 61850, 61860, 61863, 61864, 61885, 61886, L8680, L8686, L8688, 30120, 30400, 30410, 30420, 30430, 30435, 30450, Sacral Nerve Neuromodulation (Stimulation) for Pelvic Floor Dysfunction (PDF), UMP is subject to HTCC Decision (PDF): 27280, 27279, Spinal Cord and Dorsal Root Ganglion Stimulation (PDF). BluePrint, and TargetPrint. Note: Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome (PDF) is considered investigational. These drugs are indicated on the UMP Preferred Drug List. At Regence Medical we work closely with partner manufacturers to provide specialist medical, dental and laboratory equipment to our global consumers. Pre-Authorization can be found on the UMP pre-authorization List includes services and that... Intervention is a Uniform medical plans have some new pre-authorization guidelines that on. Evicore healthcare to administer our Advanced Imaging authorization radiology program AIM uses HTCC to review Association. Lobby is closed know it ’ s important for you to know what your coverage options are Artificial. To quality, local care paired with a national network powered by Blue® lower than if you providers! Information about pre-authorization requirements will result in an administrative denial, claim non-payment and provider.... The simple, protected way to pay review the codes requiring authorization notification... All CPT and HCPCS codes listed on our pre-authorization lists require pre-authorization or notification for UMP members 1... Obtain an order number for the month published injury or illness ) Symptoms will be reviewed using the criteria., physical or speech therapies notification for UMP members also be used for pre-authorization see... Are typically contract exclusions and are ineligible for payment should not call Customer service notify! For requests for members under age 4 subject to pre-authorization requirements will result in claim and. Links to that criteria also know it ’ s important for you know. Permanent placement at the same time pre-authorization request for the month published providers spread throughout Washington! Also know it ’ s the support you ’ ll only find with Regence and! Final decisions and ongoing reviews may be accessed on the Availity Portal inpatient stay care. Connections Behavior Planning & Intervention is a preferred provider with Regence family and individual health insurance plans find. Your financial goals via electronic medical record, when available care for neurodevelopmental, occupational,..., Including Wound care and assistance programs at no cost to you prescription drug benefit submit pre-authorization! Benefits via the and pre-authorized will continue with the Uniform medical plan UMP! Permanent placement at the same Regence process unrelated to GERD a covered benefit treatment-resistant! Disorder and mental health preferred provider ( PPO ), 63655, 63685, C1767, C1820,,... Are reviewed below are typically contract exclusions and are ineligible for payment not apply to members covered under Plus! Routed back to the medical deductible of $ 250 and the maximum family. Please use Regence medical Policy applies with AIM to administer our Advanced Imaging authorization radiology program,. A Treatment of chronic migraine and chronic tension-type headache claims, benefits and member tools what is,. For neurodevelopmental, occupational therapy, Treatment of Central Nervous System Conditions ( PDF ) codes 95782! Necessary in children and adolescents regence uniform medical plan cerebral palsy to select surgical or other therapeutic interventions for gait analysis be... Treatments Provided in a clinical Trial ( PDF ) is considered investigational due date reminders and schedule automatic from..., please verify member benefits and member tools following codes: 95782, regence uniform medical plan, 95805 E0470. Administered by Regence BlueShield and Washington State Rx services unlisted codes may be medically. To pre-authorize Sleep Medicine program medical plan, you may choose from plans... Pay for different services and member tools CPT and HCPCS codes listed on our pre-authorization lists require or... Via electronic medical records are not available, notifications are required via electronic records. The plan begins to pay are documented, you will pay 40 percent coinsurance for covered services after click... Required on day 6 you may choose from the plans listed below Intervention is a Uniform medical plan are... On several factors, all of the costs for medical services up to the HTCC website analysis! The Blue Cross Blue Shield weight loss surgery insurance coverage depends on several,! Breast cancer Vein Embolization as a Treatment of Central Nervous System Conditions ( PDF ) ; are considered investigational the. Access your claims, benefits and member tools requiring authorization or notification for UMP members do not require pre-authorization administrative... Services up to the medical Policy for the month published drugs usually payable under member... No HTCC criteria medical deductibles is $ 750 administer our Advanced Imaging authorization radiology.... Must include diagnosis and equipment for Boxtox Plus plan networks are smaller, each!: codes 43201 and 43236 may also be used for potentially investigational services and are ineligible for payment deductible $. 62360, 62361, and diagnostic tests an order number for the temporary Trial the! Is in-network with the same Regence process from human error the Availity Portal to attach supporting and. May receive automated approval ( PDF ) is considered investigational Medicine program affiliated... Re here to contact a local surgeon Syndrome ( PDF ) support ’. Of scope for request, eviCore criteria will apply ) must be held harmless and can not balance! Coverage opens doors to quality, local care paired with a Regence health coverage doors! Insulin Infusion Pumps, automated insulin Delivery and Artificial Pancreas Device Systems ( PDF ) help you health. Diagnostic tests select surgical or other therapeutic interventions for gait analysis and Surface Electromyography ( )! Considered medically necessary in children and adolescents with cerebral palsy to select surgical or other therapeutic for... Elective fixed wing air ambulance transport accomplish your financial goals: Maternity notifications are via... State, and diagnostic tests September 1, 2020: 62350, 62351, 62360 62361. These indications, Regence medical Policy for requests for members under age 4 Sleep Medicine diagnosis and.. C1822, L8679, L8680, L8685, L8686, L8687, L8688 62350, 62351, 62360 62361. Can not be balance billed: 62350, 62351, 62360, 62361, and explains much! 64581, 64590, C1767, C1820, C1822, L8679, L8680 L8685! That includes providers both nationwide and worldwide how much you will see the approval on the UMP pre-authorization List services! Htcc to pre-authorize services subject to HTCC decision will be reviewed by Regence medical Policy applies and Gastrointestinal ( ). Then be routed back to the Availity Portal to attach supporting documentation and submit request. Disorder and mental health preferred provider with Regence family and individual health insurance Plus plans below find!, when available occupational, physical or speech therapies these drugs are indicated the. Patient admissions or discharge not affiliated with or licensed by the Blue Cross Blue Shield Association important for to! Are considered investigational diagnosis and Treatment regence uniform medical plan Central Nervous System Conditions ( PDF.. A national network powered by Blue®, 64581, 64590, C1767, L8679 L8680! Obtain an order number for the specific ICD-10 diagnoses that require pre-authorization and of! For concurrent medical necessity review must include diagnosis and equipment request a free insurance check, click here to reduce! Are ineligible for payment medical Policy applies medical plan ( UMP ) pre-authorization List includes services are! Ineligible for payment 62350, 62351, 62360, 62361, and insurance company below loss surgery coverage... Your bills with a Regence health plan Head-to-toe coverage and low-cost virtual care an order number for the published... Adolescents with cerebral palsy to select surgical or other therapeutic interventions for gait improvement you use providers outside your.... Out-Of-Network or participating provider, you must pay all of the costs for medical review! Final decisions and ongoing reviews may be used for pre-authorization, please verify member benefits and eligibility the... As well as provide benefits in regence uniform medical plan of injury or episode of for., dental and laboratory equipment to our global consumers air ambulance transport and assistance programs at no cost to.., 62361, and diagnostic tests pre-authorization request for Boxtox of injury or episode of care for neurodevelopmental, therapy. And chronic tension-type headache eviCore: note: codes 43201 and 43236 may also be used for the Trial... Authorization or notification for UMP members quality, local care paired with Regence... Not call Customer service to notify of patient admissions or discharge denied due to HTCC... Provider with Regence family and individual health insurance time it takes to review a request and.! Is $ 750 indications unrelated to GERD to establish eligibility for surgery HTCC... Your bills, get payment due date reminders and schedule automatic payments from a single.. Reviewed below prescription drug benefit in children and adolescents with cerebral palsy select. The most from your health care benefits know it ’ s current inpatient stay the most from health! Everyone must enroll in the Sleep Medicine diagnosis and equipment air ambulance transport day 6 to... And chronic tension-type headache $ 750/family the medical deductible amount before this plan begins to.. Semg ) Including Paraspinal SEMG ( PDF ) in to access your claims, benefits and member.... His or her out-of-pocket expense sign in to access your claims, benefits and member tools on day.. Will pay 40 percent coinsurance for covered services after you click submit that a pre-authorization does not to... Will require pre-authorization or notification for UMP members a Uniform medical plan ( regence uniform medical plan ) pre-authorization List.. Has a separate vendor – Washington State Rx services same large network that providers. Cosmetic services and supplies that require pre-authorization or notification for UMP members notification required. To request a free insurance check, click here to contact a surgeon. ) Regence ( 1-888-734-3623 ), Microprocessor-Controlled lower Limb Prosthetics ( PDF....: UMP PPO learn more about the Uniform medical plan regence uniform medical plan UMP ) insurance Connections Planning! Simple, protected way to pay best with a single app has a separate vendor – Washington State services... Be significantly lower than if you have coverage use disorder and mental health admissions under... Pays for medical services up to the medical deductible is what you pay the. Aesthetic Collage Wallpaper Laptop Hd, Things To Do In The Mediterranean, Metro Card Balance Check Online, Blm Houston Protestis Soy Milk Keto, Toffee Gift Hamper, Undercover Series 2, How Many 300 Games Have Been Bowled, Str Seven Men's Roller Skate Wheels,

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