Provider Criteria
- Utilization Management Criteria
- Medicare National and Local Coverage Determinations
https://www.cms.gov/medicare-coverage-database/indexes/national-and-local-indexes.aspx - Medicare Benefit Policy Manual
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS012673.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=ascending - Medicare Managed Care Manual
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS019326.html?DLPage=2&DLEntries=10&DLSort=0&DLSortDir=ascending - Medical Policy of the Member’s Health Plan
Please contact Concerto at 1-877-597-1440 for details - MCG (Milliman Care Guidelines) current edition
Please contact Concerto at 1-877-597-1440 for details