CarePartners of Connecticut Medical Necessity Guideline Updates
Providers and office staff can refer to the following chart to review changes and updates to CarePartners of Connecticut’s Medical Necessity Guidelines, which detail coverage and prior authorization criteria.
MNG Title | Effective Date | Summary |
Out-of-Network Coverage at the In-Network Level of Benefits and Continuity of Care | 7/9/2024 | We have developed these Medical Necessity Guidelines to document the prior authorization standard when CarePartners of Connecticut is responsible for determining whether it is medically necessary for the member to receive services from an out-of-network provider, as well as our continuity of care criteria for medically necessary transitional treatment for new members who wish to stay with their current providers and treatments for a defined period of time until they can transition care to in-network providers.
|