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Group Information for Providers

Medical Policy Announcements

Beginning January 1, 2014, the medical policy criteria for vein disease treatment will change. The medical policy titled; “Vein Disease Treatment (Endoluminal Radiofrequency Ablation, Endovenous Laser Ablation, Sclerotherapy or Ultrasound-guided Sclerotherapy” has been changed. The changes were published on page 4 in the Fall Provider News and will become effective on 01/01/2014. The criteria for radiofrequency ablation and endovenous laser ablation, as well as other treatments for vein disease will change. The documentation required will include detailed office notes and signed ultrasound reports. The criteria for sclerotherapy will not change, and will continue to require prior authorization.

Sample ID Cards

For specific information, please contact the group’s customer service number located on the ID card or under the group number on the Medical Management website.
Dean EPO    Dean PPO    Prevea360 EPO    Prevea360/HealthEOS EPO

Prior Authorization Summary

To determine group specific Prior Authorization requirements, click on the Group # as listed on the member’s ID card.  Please carefully select the Group #, prior authorizations are different based on the plan the employer offers.

DHP9293

Please see the below list of Prior Authorization requirements for Group # DHP9293.
For further questions, please contact Customer Service at (800) 952-7416. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

DHP13103KX

Please see the below list of Prior Authorization requirements for Group # DHP13103KX.
For further questions, please contact Customer Service at (888) 895-1188. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

  • Prior Authorization List for 1/1/15-12/31/15
  • Radiology Prior Authorization starting on 4/1/15
  • Medical Injectables
  • Federally Mandated Contraceptive Services Coverage
    DHP13103KX has certified they are eligible for an accommodation under the Affordable Care Act (ACA) that allows their Medical & Pharmacy plan to refrain from covering the contraceptive services for women that are required under the ACA. This accommodation requires Dean Health Plan, as the administrator for DHP13103KX, to provide coverage for approved contraceptive services without charging a copayment, coinsurance, or deductible for all eligible members under DHP13103KX Health Plan. DHP13103KX will not contract, arrange, pay, or refer for such coverage. Please visit the Contraceptive Services Coverage page for additional information on contraceptive coverage.

DHP18510

Please see the below list of Prior Authorization requirements for Group # DHP18510.
For further questions, please contact Customer Service at (877) 366-3900. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

  • Prior Authorization List for 1/1/15-12/31/15
  • Radiology Prior Authorization starting on 4/1/15
  • Medical Injectables
  • Federally Mandated Contraceptive Services Coverage
    DHP18510 has certified they are eligible for an accommodation under the Affordable Care Act (ACA) that allows their Medical Pharmacy plan to refrain from covering the contraceptive services for women that are required under the ACA. This accommodation requires Dean Health Plan, as the administrator for DHP18510, to provide coverage for approved contraceptive services without charging a copayment, coinsurance, or deductible for all eligible members under DHP18510 Health Plan. DHP18510 will not contract, arrange, pay, or refer for such coverage. Please visit the Contraceptive Services Coverage page for additional information on contraceptive coverage.

DHP33240

Please see the below list of Prior Authorization requirements for Group # DHP33240.
For further questions, please contact Customer Service at (877) 559-2432. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

DHP33640

Please see the below list of Prior Authorization requirements for Group # DHP33640.
For further questions, please contact Customer Service at (888) 577-7724. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

DHP33810

Please see the below list of Prior Authorization requirements for Group # DHP33810.
For further questions, please contact Customer Service at (888) 795-2432. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

DHP33870

Please see the below list of Prior Authorization requirements for Group # DHP33870.
For further questions, please contact Customer Service at (877) 230-7579. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

DHP33950

Please see the below list of Prior Authorization requirements for Group # DHP33950.
For further questions, please contact Customer Service at (888) 779-2432. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.

DHP38660

Please see the below list of Prior Authorization requirements for Group # DHP38660.
For further questions, please contact Customer Service at (800) 758-8146. Note: DHP will utilize medical policies as criteria for all medical reviews with DeanASO product line.