Medical Necessity Criteria & Clinical Practice Guidelines

Under Banner Health Plans (BHP), our medical necessity criteria and clinical practice guidelines are applicable to:

Banner – University Family Care/AHCCCS Complete Care (B – UFC/ACC)
Banner – University Family Care/Arizona Long Term Care System (B – UFC/ALTCS)
 

Medical Necessity Criteria

Medical necessity criteria used by BHP in clinical decision-making.

Clinical Practice Guidelines

Our clinical practice guidelines are endorsed or developed with designated, desired outcomes and associated, standardized measures of effectiveness.