Prevea360 Medical Management

We pride ourselves on our close partnership with you, our providers. We know that caring for your patients is your top priority and so we designed this page to provide easy access to our medical policies and prior authorization requirements. Medical policies are reviewed annually by our Medical Director Committee and all changes and updates will be posted here on a quarterly basis.

Most Used Authorization & Coverage Documents

Medical Prior Authorization List - current procedures and services that include the most common CPT codes that require a prior authorization.
Non-covered Services
Non-covered Durable Medical Equipment/Supplies

Prevea360 Health Plan Medical Policies

Prevea360 medical policies are procedures and services criteria developed from evidence-based medicine to assist in coverage determination. Click below to search for keywords in the list to find the Prevea360 Health Plan policy you would like to reference.

Search Prevea360 Health Plan Medical Policies | Search Prevea360 Health Plan Drug Policies

Medical Policy Updates:

Fall 2016

Spring 2014

Winter 2013

Fall 2013