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Medical policies and clinical utilization management guidelines update (Healthy Blue + Medicare (HMO D-SNP)) July 14, 2023 Blue Medicare Medical Policy & Clinical Guidelines

Please note, this communication applies to Healthy Blue + Medicare℠ (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).

The Medical Policies, Clinical Utilization Management (UM) Guidelines and Third-Party Criteria (PDF) were developed and/or revised to support clinical coding edits. Note, several policies and guidelines were revised to provide clarification only and are not included. Existing precertification requirements have not changed.

Please share this notice with other providers in your practice and office staff.

To view a guideline, visit Healthy Blue + Medicare. 

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

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