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Clinically Appropriate Care

We approve care that is clinically right or appropriate. This just means the services or supplies you get are standard. Standards are set by national guidelines, such as InterQual.

You, your authorized representative or provider can look over the information used to make your appeal decision, including:

  • Your medical records
  • Guidelines we used
  • Our appeal policies and procedures

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Last Updated On: 4/20/2021