By continuing to
the medical policy manual, you understand and
agree to the following terms and conditions:
Medical Policy Manual Terms and Conditions
Description
The Regence Group® (TRG) Medical Policy Manual contains
Medical Policies approved by TRG. Medical Policies are
based upon research that provides evidence of scientific
merit for a particular medical technology. Technology
determinations are made using criteria developed by
the BlueCross BlueShield Association's® Technology
Evaluation Center.
Use
TRG Plans use Medical 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 Medical 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
- Medical 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.
- Medical Policies are interpreted and applied in
the sole discretion of the Plan.
- Medical Policy application is subject to state and
federal laws and specific instructions from Plan Sponsors
of self-insured groups.
- Medical Policies DO NOT constitute medical 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.
- Medical 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 Medical 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
Medical Policies displayed may be out of date.
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