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Clinical guidelines and policy bulletins

Pautas

Respected professional and public health organizations create clinical practice guidelines that document best practices and recommendations for care. We’ve chosen certain clinical guidelines to help our providers give members high-quality, consistent care with effective use of services and resources. Estas pautas incluyen protocolos de tratamiento para afecciones específicas, así como también medidas de salud preventivas.

 

The intention of these guidelines is to clarify standards and expectations. No deben:

 

  • Take precedence over your responsibility to provide treatment based on the member’s needs
  • Sustituir los pedidos de tratamiento de un miembro
  • Garantizar la cobertura o el pago por el tipo o nivel de atención propuesta o proporcionada

Boletines sobre políticas clínicas

These bulletins state our policy about the medical necessity or investigational status of medical technologies and other services to help with coverage decisions. A national review team creates the bulletins and bases them on:

 

  • Published medical literature
  • Formal technology assessments
  • Structured evidence reviews
  • Evidence-based consensus statements
  • Expert opinions
  • Evidence-based guidelines from professional and public health entities 

 

Aetna® clinical policy bulletins

 

Boletines sobre políticas clínicas médicas de Aetna 

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