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Políticas Médicas
Las políticas médicas son documentos que definen el reconocimiento de cubierta para tecnologías, procedimientos y tratamientos. Las declaraciones de necesidad médica en las políticas, sobre si una tecnología, procedimiento, tratamiento, suplido, equipo, medicamento u otro servicio mejora el resultado en la salud de la población para la cual dicha tecnología o tratamiento fue diseñado se basan en evidencia científica, estudios clínicos y opiniones profesionales de nuestros proveedores y de las organizaciones médicas reconocidas.
Cada documento desplegado en este sitio Web se provee con propósitos informativos solamente y no es una autorización, explicación de beneficios o un contrato. El recibir beneficios está sujeto a la satisfacción de todos los términos y condiciones de la cubierta. La tecnología médica cambia constantemente y nos reservamos el derecho de revisar y actualizar nuestras políticas periódicamente.
| ID | Título | Última Revisión | Siguiente Revisión | Descripción | Acceso |
|---|---|---|---|---|---|
| 03.001.001 | Psycotheraphy | Nov 11, 2020 | Policy Archived | The patient receives medical evaluation and management services. these services involve a variety of unique,... | Ver |
| 03.001.004 | TERAPIA ELECTROCONVULSIVA | May 10, 2016 | Policy Archived | La terapia electroconvulsiva se considera para pago como tratamiento para la depresión mayor, desórdenes... | Ver |
| 03.001.005 | AUTISM DISORDERS / PERVASIVE DEVELOPMENT DISORDERS | Dec 26, 2024 | Policy Archived | Triple - s will cover for payment the following services as medically necessary in the evaluation of a known... | Ver |
| 03.001.006 | PSYCHIATRY SERVICES | Nov 14, 2019 | Policy Archived | Psychiatric services are medically... | Ver |
| 03.001.007 | HOME PSYCHIATRIC SERVICES | Nov 14, 2019 | Policy Archived | Psychiatric services in the home will be covered for payment when they comply with what is expressed in the... | Ver |
| 03.001.008 | Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity Disorder, Cognitive Impairment, or Autism Spectrum Disorder | Nov 06, 2024 | Nov 20, 2025 | Patients with attention-deficit/hyperactivity disorder (adhd) may have alterations in their brain wave... | Ver |
| 03.001.009 | Digital Health Therapies for Substance Use Disorders | Aug 22, 2024 | Policy Archived | Digital health therapies for individuals with substance use disorders are... | Ver |
| 03.001.010 | Digital Health Technologies for Attention Deficit/Hyperactivity Disorder | Aug 22, 2024 | Aug 20, 2025 | Digital health technologies is a broad term that includes categories such as mobile health, health... | Ver |
| 03.003.001 | Therapeutic Radiopharmaceuticals for Prostate Cancer | Nov 26, 2024 | Nov 20, 2025 | Therapeutic radiopharmaceuticals for prostate cancer using lutetium (lu) 177 vipivotide tetraxetan... | Ver |
| 04.001.001 | Antepartum Fetal Evaluation | Jun 16, 2022 | Policy Archived | Conditions for which antepartum evaluation is considered for payment: decrease in fetal movements... | Ver |
| 04.001.003 | Home Uterine Activity monitoring | May 08, 2019 | Policy Archived | Home uterine activity monitoring through a monitoring device and/or daily nursing contact is considered not... | Ver |
| 04.001.007 | Occlusion of Uterine Arteries Using Transcatheter Embolization | Sep 21, 2020 | Sep 21, 2021 | Transcatheter embolization of uterine arteries as a treatment of uterine fibroids or as a treatment of... | Ver |
| 04.001.009 | Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids | Mar 18, 2024 | Mar 20, 2025 | Laparoscopic or transcervical radiofrequency ablation (rfa) as a treatment of symptomatic uterine fibroids is... | Ver |
| 04.001.010 | OCLUSION HISTEROSCOPICA DE LOS TUBOS DE FALOPIO COMO METODO CONTRACEPTIVO | May 16, 2016 | Policy Archived | La oclusión histeroscópica de los tubos de falopio como método de esterilización permanente se considera... | Ver |
| 04.001.011 | Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome | Sep 18, 2024 | Sep 20, 2024 | Endovascular occlusion of the ovarian vein and internal iliac veins is considered investigational as a... | Ver |
| 04.001.012 | Progesterone Therapy as a Technique to Reduce Preterm Delivery in High-Risk Pregnancies | Oct 22, 2024 | Policy Archived | For individuals with a singleton pregnancy and prior spontaneous preterm birth before 37 weeks of gestation,... | Ver |
| 04.001.017 | INTERRUPCION QUIRURGICA DEL NERVIO PELVICO COMO TRATAMIENTO DE DISMENORREA PRIMARIA O SECUNDARIA | Nov 16, 2017 | Policy Archived | Ablación laparoscópica del nervio uterino (lu) y la neurectomia presacral laparoscópica (lpsn) no se... | Ver |
| 04.001.019 | Robotic Surgery in Gynecology | Oct 26, 2023 | Policy Archived | The robot-assisted gynecologic surgery (robotic surgery) is considered a modality of conventional... | Ver |
| 04.001.020 | Obstetric Ultrasonography | Sep 11, 2024 | Policy Archived | Ultrasonographic evaluation of the fetomaternal complex in the different stages of pregnancy is considered... | Ver |
| 04.001.024 | SERVICES FOR INTRA-UTERINE DEVICE MANAGEMENT | Nov 09, 2022 | Policy Archived | Intrauterine devices are considered medically necessary in the prevention of... | Ver |
