Policies, Procedures, & Guidelines

The policies, procedures, and guidelines page provides information to providers in the form of clinical policies and guidelines.

Clinical policies and guidelines are utilized by Community Health Network of Connecticut, Inc.® (CHNCT), when reviewing requests for the prior authorization (PA) of various goods and services. The criteria, included in the policies, are based on the best clinical evidence available. All requests are reviewed in accordance with the Department of Social Services' (DSS) definition of medical necessity. Prior authorization means the approval from the Department of Social Services (DSS), or a contracted agent (in this case CHNCT), of a service or the delivery of goods before the provider actually performs the service or delivers the goods.

Important

To receive reimbursement from the DSS, a provider must comply with all Prior Authorization (PA) requirements. Obtaining PA does not guarantee payment or ensure client eligibility. It is the responsibility of the provider to verify client eligibility for the appropriate date(s) of service.

Clinical Policies

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Parenteral/Enteral Supplies

Clinical Guidelines

Cancer Screening Recommendations and Guidelines:

U.S. Preventive Services Task Force (USPSTF). Rockville, MD. [Created in 1984, the U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine. Since 1998, the Agency for Healthcare Research and Quality (AHRQ) has been authorized by the U.S. Congress to convene the Task Force and to provide ongoing scientific, administrative, and dissemination support to the Task Force.]

Link provided with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). © National Comprehensive Cancer Network, Inc. All rights reserved. To view the most recent and complete version of the guideline, go online to www.nccn.org.

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

This portion of the HUSKY Health website is managed by Community Health Network of Connecticut, Inc.®, the State of Connecticut’s Medical Administrative Services Organization (ASO) for the HUSKY Health program. For the general HUSKY Health website gateway, please visit portal.ct.gov/husky. HUSKY Health includes Medicaid and the Children’s Health Insurance Program, and is administered by the Connecticut Department of Social Services (DSS).

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