New Clinical Policy Information
Optima Health has a new repository for clinical policies. There are also new authorization requirement changes that can be found at this link. Please review to ensure compliance with authorization requirements.
Additionally, as part of the ongoing work to align clinical requirements for our health plans we have identified over 100 services for government programs that will no longer require authorization effective July 1. Notable changes will include removing authorization requirements for routine telemonitoring services and are making platelet-rich plasma injection more generally available to our members when clinical criteria are met. Please continue to monitor the clinical policy repository for changes as we work to identify continued opportunities to make Optima Health member care easier for our provider community.
Provider Alert: Authorizations Temporarily Not Viewable- Date Span Correction and Medicaid Authorizations Update
Provider Alert: Payment Policies and SHP Updates
Provider Alert: Sentara Health Plans, Cardinal Care Updates, and More
Provider Alert: New CMR Process