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Medical clinical policy bulletins

Clinical Policy Bulletins | Dental Policy Bulletins | Pharmacy Policy Bulletins

How CPBs are used
Medical CPBs state our policies on the experimental and investigational status and medical necessity of medical technologies and services.

Our professional staff sometimes uses clinical policy bulletins as a health care policy guide in making medical coverage decisions for members. They also refer to the member’s health plan and use other criteria we’ve established.

How CPBs are developed
Our CPBs are based on objective, credible sources:

Evidence in the peer-reviewed published medical literature
Technology assessments and structured evidence reviews
Evidence-based consensus statements
Expert opinions of healthcare providers
Evidence-based guidelines from nationally recognized professional healthcare organizations and public health agencies.

CPBs can be technical. Members and consumers should talk about the information in them with their doctors. This helps in more fully understanding CPBs.

We hope you find this information useful and welcome your feedback.

How to find them