Review ConnectiCare's policies on various medical treatments and emerging medical technologies.
Services That Require Preauthorization
View EmblemHealth Medical Policies
In addition to the medical coverage policies listed below, the following resources are used to make medical necessity determinations.
Policy Name | Download (PDF) |
---|---|
Abdominoplasty-Panniculectomy | Download (PDF) |
Autologous Chondrocyte Implantation | Download (PDF) |
Automatic External Defibrillators | Download (PDF) |
Balloon Sinuplasty | Download (PDF) |
Bariatric Surgery | Download (PDF) |
Biomagnetic Therapy | Download (PDF) |
Blepharoplasty | Download (PDF) |
Breast Implants and Reconstruction | Download (PDF) |
Cardiac Event Monitoring | Download (PDF) |
Chemical Peels | Download (PDF) |
Clinical Trial | Download (PDF) |
Cochlear and Other Auditory Implants | Download (PDF) |
Continuous Passive Motion Devices | Download (PDF) |
Cortical Stimulation for Epilepsy (NeuroPace®) | Download (PDF) |
Cosmetic and Reconstructive Surgery Procedures | Download (PDF) |
Deep Brain Stimulation | Download (PDF) |
Dermabrasion | Download (PDF) |
Experimental Investigational or Unproved Services Policy | Download (PDF) |
Fecal Incontinence Treatment | Download (PDF) |
Fetal Surgery | Download (PDF) |
Gastric Electrical Stimulation | Download (PDF) |
Gender Affirming Surgery | Download (PDF) |
Glaucoma Surgery | Download (PDF) |
High Frequency Chest Wall Oscillation Devices and Intrapulmonary Percussive Ventilators | Download (PDF) |
Home Birth Midwifery Services | Download (PDF) |
Home Care Services | Download (PDF) |
Hyperbaric Oxygen Therapy | Download (PDF) |
Implantable Cardioverter Defibrillators | Download (PDF) |
Infertility | Download (PDF) |
Insulin Delivery Devices and Continuous Glucose Monitoring Systems | Download (PDF) |
Lyme Disease Intravenous Treatment | Download (PDF) |
Mechanical Stretching Devices | Download (PDF) |
Neuropsychological Testing | Download (PDF) |
Non-Emergent Ambulance Services | Download (PDF) |
Obstructive Sleep Apnea Diagnosis and Treatment | Download (PDF) |
Ocular Photoscreening Policy | Download (PDF) |
Omnibus Policy
|
Download (PDF) |
Oral Surgery | Download (PDF) |
Orthognathic Surgery | Download (PDF) |
Osteochondral Grafting |
Download (PDF) |
Otoacoustic Emissions Testing Policy | Download (PDF) |
Penile Implants | Download (PDF) |
Peripheral Nerve Block | Download (PDF) |
Phototherapy Photochemotherapy Photodynamic Therapy | Download (PDF) |
Posterior Tibial Nerve Stimulation for Voiding Dysfunction | Download (PDF) |
Pulsed Dye Laser Therapy for Cutaneous Vascular Lesions | Download (PDF) |
Radiofrequency Ablation for Spinal Pain | Download (PDF) |
Radiofrequency Ablation for Tumors | Download (PDF) |
Reduction Mammoplasty | Download (PDF) |
Rhinoplasty | Download (PDF) |
Septoplasty | Download (PDF) |
Surgical Correction Chest Wall Deformities | Download (PDF) |
Transcatheter Aortic Valve Replacement | Download (PDF) |
Vacuum-Assisted Wound Closure | Download (PDF) |
Varicose Vein Treatment | Download (PDF) |
Vertical Expandable Prosthetic Titanium Rib (VEPTR) | Download (PDF) |