Using Clinical Coverage Criteria to Determine Medically Necessary Covered Care.
NHP medical policies, or clinical coverage criteria, help us evaluate the safety and effectiveness of a service or technology to determine if it should be covered. We base our medical policies on objective, reliable resources such as:
- Guidelines from nationally recognized health care organizations
- Peer-reviewed medical journals
- Reports from professional organizations and government agencies
- Expert opinions from health care professionals
- Evidence-based consensus statements
We review all of our medical policies at least once a year, and we make updates whenever it's appropriate.
To see the medical policy or clinical coverage criteria for a specific condition, simply click a link below*. The documents outline coverage criteria for all NHP members. However, the NHP medical policies will not tell you whether a service or technology is covered under your plan.
Log into MyNHP.org to find personalized information about your covered benefits.
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
For more information about our medical policies or about your plan, please call the Customer Service number on the back of your member ID card or email firstname.lastname@example.org.