This functionality is implemented using Javascript. It cannot work without it, etc...

Estamos cargando la información...

Saltar al contenido

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
07.001.082 Bronchial Valves Jul 10, 2023 Jul 20, 2024 Bronchial valves are considered investigational in all situations including, but not limited to: treatment... Ver
07.001.083 SURGERY OF PARANASAL SINUSES GUIDED BY IMAGES  Nov 11, 2020 Policy Archived Image-guided surgery is recognized for payment for the following indications: revision of surgery on the... Ver
07.001.084 FUSION VERTEBRAL LUMBAR MINIMAMENTE INVASIVA Aug 22, 2017 Policy Archived Los siguientes procedimientos se reconocen para pago: fusión anterior: alif-abierto fusión posterior:... Ver
07.001.085 Autologous Fat Grafting to the Breast and Adipose-Derived Stem Cells Oct 26, 2020 Policy Archived The use of autologous fat grafting to the breast, with or without adipose-derived stem cells, is considered... Ver
07.001.086 Image-Guided Minimally Invasive Decompression for Spinal Stenosis May 05, 2023 May 20, 2024 Image-guided minimally invasive spinal decompression is... Ver
07.001.088  Lung Volume Reduction Surgery for Severe Emphysema Sep 08, 2023 Sep 20, 2024 Lung volume reduction surgery as a treatment for emphysema may be considered medically necessary in patients... Ver
07.001.089 SEPTOPLASTY Nov 10, 2021 Policy Archived Septoplasty it is considered medically necessary when any of the following clinical conditions is present:... Ver
07.001.090 Microwave Tumor Ablation Nov 15, 2023 Nov 20, 2024 Microwave ablation of primary or metastatic hepatic tumors may be considered medically necessary under the... Ver
07.001.091 Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures May 04, 2023 May 20, 2024 Either invasive or noninvasive methods of electrical bone growth stimulation may be considered medically... Ver
07.001.092 Interspinous Fixation (Fusion) Devices May 23, 2023 May 20, 2024 Interspinous fixation (fusion) devices are considered investigational for any indication, including but not... Ver
07.001.094 Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease Dec 13, 2023 Dec 20, 2024 Magnetic esophageal sphincter augmentation to treat gastroesophageal reflux disease is investigational.... Ver
07.001.095 COBLATION ASSISTED TONSILECTOMY Nov 10, 2021 Policy Archived Tonsillectomy by coblation is not considered for additional payment for the treatment of any of the following... Ver
07.001.096 Magnetic Resonance-Guided Focused Ultrasound Aug 08, 2023 Aug 20, 2024 Magnetic resonance-guided high-intensity ultrasound ablation may be considered medically necessary for pain... Ver
07.001.097 Transcatheter Closure of Patent Ductus Arteriosus Jun 13, 2019 Policy Archived Transcatheter closure of a patent ductus arteriosus using an fda-approved device may be considered medically... Ver
07.001.098 Debridment Oct 12, 2022 Policy Archived Triple-s salud considers payment for debridement when provided by the surgeon for the management of ulcers or... Ver
07.001.099 Hip Resurfacing May 05, 2023 May 20, 2024 Metal-on-metal total hip resurfacing with a device system approved by the u.s. food and drug administration... Ver
07.001.100 Cryosurgical Ablation of Primary or Metastatic Liver Tumors Oct 10, 2023 Oct 20, 2024 Cryosurgical ablation of either primary or metastatic tumors in the liver is... Ver
07.001.101 Subtalar Arthroereisis May 05, 2023 May 20, 2024 Subtalar arthroereisis is considered... Ver
07.001.102 Lumbar Spinal Fusion Oct 18, 2023 Oct 20, 2024 Lumbar spinal fusion may be considered medically necessary for any one of the following conditions:... Ver
07.001.103  Transcatheter Aortic Valve Implantation for Aortic Stenosis Mar 15, 2024 Mar 20, 2025 Transcatheter aortic valve replacement with a u.s. food and drug administration (fda) approved transcatheter... Ver

Últimos Artículos

Línea de atención Telexpreso

(787) 774-6060

TTY/TDD (787) 792-1370

Servicio al cliente Postal

(787) 474-5219

TTY/TDD 1-866-620-2520

Lunes a Viernes de 7:30 am a 8:00 pm (AST)
Sábados de 9:00 am a 6:00 pm (AST)
Domingos de 11:00 am a 5:00 pm (AST)

Línea de atención (libre de cargo)

1-800-981-3241

TTY/TDD 1-866-215-1999

Lunes a Viernes de 7:30 am a 8:00 pm (AST)
Sábados de 9:00 am a 6:00 pm (AST)
Domingos de 11:00 am a 5:00 pm (AST)

Centro de Llamadas de Servicios al Proveedor

1-877-357-9777

Lunes a Viernes de 7:30 am a 8:00 pm
Sábados de 8:00 am a 12:00 pm

Teléfono de Ventas

(787) 277-6644

Lunes a Viernes de 8:00 am a 4:30 pm (AST)

Administradores de Grupo y Productores

(787) 749-4519

Lunes a Viernes de 8:00 am a 5:00 pm (AST)

Teléfono de Ventas de Grupos

(787) 277-6664

Orientación Medicare Advantage

(787) 792-3508

Lunes a Viernes de 8:00 am a 6:00 pm (AST)

Planes Médicos

Triple-S Salud

Herramientas para ti

 

Ir arriba
787-277-6653 787-474-6326