By continuing
to the behavioral health policy manual,
you understand and agree to the following terms
and conditions:
Behavioral Health Policy Manual Terms and Conditions
Description
The Regence Group® (TRG) Behavioral Health Policy
Manual contains Behavioral Health Policies approved
by TRG. Behavioral Health Policies are informed by
evidence-based treatment guidelines as well as clinical
best practices/standards of care. They are consistent
with Milliman, SAMHSA and culturally competent practice
philosophy and standards.
Use
TRG Plans use Behavioral Health Policies as guidelines
for coverage determinations in all health care insurance
products, unless otherwise indicated. TRG Plans include
Regence BlueShield®, Regence BlueCross BlueShield
of Oregon®, Regence BlueCross BlueShield of Utah®,
and Regence BlueShield of Idaho®, and any of their
affiliated or subsidiary companies.
Conflict with Plan Documents
In the event of a conflict between a Behavioral Health
Policy and any Plan document under which a member is
entitled to Covered Services, the Plan document will
govern. Plan documents include, but are not limited
to, Subscriber Contracts, Summary Plan Documents, and
other coverage documents prepared by a Plan.
Restrictions and Limitations
Behavioral Health Policies DO NOT determine the schedule
of benefits. Rather, Medical Policies are used in the
process to determine if a service will be paid by a
Plan.
Behavioral Health Policies are interpreted and applied
in the sole discretion of the Plan.
Behavioral Health Policy application is subject to
state and federal laws and specific instructions from
Plan Sponsors of self-insured groups.
Behavioral Health Policies DO NOT constitute behavioral
health advice and DO NOT guarantee any results
or outcomes. If you are a member, you should
discuss any related health care questions with your
health care provider.
Behavioral Health Policies are the property of TRG
and you are strictly prohibited from using them for
any commercial use whatsoever. Commercial use does
not include use of the Behavioral Health Policies for
purposes related to the health care of a TRG Plan member.
In addition, Current Procedural Terminology (CPT®)
codes and descriptions are the property of the American
Medical Association with all rights reserved.
There is no obligation to update this site and the
Behavioral Health Policies displayed may be out of
date.
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