Medical Policy Selection

Highmark’s medical policy guidelines address both clinical and claim payment reimbursement issues. These guidelines address hundreds of medical issues, including diagnostic and therapeutic procedures, injectable drugs, and durable medical equipment. Some policies address procedures and services that are considered to be part of another procedure or service and, as such, are not separately payable. Many of these clinical and reimbursement guidelines are automated in our claims processing system.

You may search for topics by Keyword, Procedure Code or Policy Bulletin Number.

Select the Medical Policy type to be viewed:

• Highmark BCBS Delaware Medical Policy
  

  Medical policy guidelines for all of Highmark BCBS Delaware's medical-surgical products, including managed care.

• Medicare Advantage Medical Policy for Highmark BCBS Delaware
  

  Medical policy information that is appropriate for Medicare Advantage products.