{"id":263,"date":"2023-10-31T14:30:12","date_gmt":"2023-10-31T14:30:12","guid":{"rendered":"https:\/\/cherryblossompace.com\/?page_id=263"},"modified":"2023-10-31T14:36:28","modified_gmt":"2023-10-31T14:36:28","slug":"provider-criteria","status":"publish","type":"page","link":"https:\/\/cherryblossompace.com\/provider-criteria\/","title":{"rendered":"Provider Criteria"},"content":{"rendered":"<h1>Provider Criteria <\/h1>\n<ul>\n<li>Utilization Management Criteria <\/li>\n<li> Medicare National and Local Coverage Determinations<br \/>\n    <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/indexes\/national-and-local-indexes.aspx\" target=\"_blank\" rel=\"noopener\"> https:\/\/www.cms.gov\/medicare-coverage-database\/indexes\/national-and-local-indexes.aspx <\/a> <\/li>\n<li> Medicare Benefit Policy Manual<br \/>\n    <a href=\"https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Internet-Only-Manuals-IOMs-Items\/CMS012673.html?DLPage=1&amp;DLEntries=10&amp;DLSort=0&amp;DLSortDir=ascending\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Internet-Only-Manuals-IOMs-Items\/CMS012673.html?DLPage=1&amp;DLEntries=10&amp;DLSort=0&amp;DLSortDir=ascending<\/a> <\/li>\n<li> Medicare Managed Care Manual<br \/>\n    <a href=\"https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Internet-Only-Manuals-IOMs-Items\/CMS019326.html?DLPage=2&amp;DLEntries=10&amp;DLSort=0&amp;DLSortDir=ascending\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Internet-Only-Manuals-IOMs-Items\/CMS019326.html?DLPage=2&amp;DLEntries=10&amp;DLSort=0&amp;DLSortDir=ascending<\/a> <\/li>\n<li>Medical Policy of the Member\u2019s Health Plan<br \/>\n    Please contact Concerto at 1-877-597-1440 for details<\/li>\n<li>MCG (Milliman Care Guidelines) current edition<br \/>\n    Please contact Concerto at 1-877-597-1440 for details<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>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&amp;DLEntries=10&amp;DLSort=0&amp;DLSortDir=ascending Medicare Managed Care Manual https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Internet-Only-Manuals-IOMs-Items\/CMS019326.html?DLPage=2&amp;DLEntries=10&amp;DLSort=0&amp;DLSortDir=ascending Medical Policy of the Member\u2019s Health Plan Please [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-no-banner.php","meta":{"_acf_changed":false,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":"","_FSMCFIC_featured_image_hide":"","footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.1 - 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