November 2009
Procedures and services deemed investigational or not medically necessary
In September, we mailed amendments/addendums to our provider agreements. The changes, effective January 1, 2010, are summarized below:
Written consent is not required for services deemed investigational. However, Regence encourages the provider to notify the member before services are rendered that they may be deemed non-covered and will be the member's financial responsibility.
Note: The Regence Clinical Edits by Code lists contain investigational codes and supporting documentation requirements.