Clinical Guidelines

Laboratory Management

Instructions for accessing the guidelines:
1.     Search by health plan name to view clinical guidelines.
2.     Locate the reason for denial section found in your letter. Identify the guideline title and then search by the provided guideline title. Select appropriate guideline document.
Example for 4Kscore for Prostate Cancer Risk Assessment: We based this decision on the guidelines listed below: 4Kscore for Prostate Cancer Risk Assessment (MOL. TS. 120).