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Clinical UM Guidelines
The “Last Review Date” set forth in the clinical UM guideline is the most recent date the Medical Policy and Technology Assessment Committee has reviewed or revised the clinical UM guideline. This is not necessarily coincident with the “Current Effective Date" which is also shown on the clinical UM guideline. For example, we may require lead time in order to program a clinical UM guideline on our claims systems. In cases where a new or revised clinical UM guideline results in the denial of benefits for services which have historically been covered, we may opt to provide advance notice of the changes prior to the clinical UM guideline taking effect. To confirm the effective date of a particular clinical UM guideline for your state or region, please contact us.
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