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 preventiva.
The intention of these guidelines is to clarify standards and expectations. No deben:
Behavioral and mental health
Trastorno relacionado con el consumo de sustancias
Trastorno relacionado con el consumo de sustancias
Maternal
Physical health
Enfermedad pulmonar obstructiva crónica (EPOC)
Insuficiencia cardiaca congestiva
Dolor en la parte inferior de la espalda
Opioids for Chronic Pain CDC Guideline
Pediatric Preventative Health Care
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:
Aetna® clinical policy bulletins
Hospice care
We work with providers to approve hospice care for members when they need end of life services and supports.
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