The Official Website Of California’s Medical Health Insurance Marketplace
While Clinical Policy Bulletins outline Aetna’s clinical policy, medical necessity determinations in reference to protection decisions are made on a case by case foundation. In the event that a member disagrees with a protection dedication, Aetna provides its members with the right to enchantment the choice. However, relevant state mandates will take priority with respect to totally insured plans and self-funded non-ERISA (e.g., government, college boards, church) plans. General practitioners Infomation for common practioners together with medical follow, maternal and child health, immunisation, infectious illnesses, medicine and poisons, psychological health, aged care and hospitals.
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- Aetna defines a service as “never efficient” when it is not acknowledged according to skilled standards of security and effectiveness in the United States for prognosis, care or therapy.
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