Good news: HPSM recently invested in MCG’s CMS Guidelines, and we want to share them with you. MCG’s Clinical Guidelines support medical-necessity reviews of health service requests, and they are now accessible to contracted network providers. This resource helps providers ensure prior authorizations meet medical necessity.
To access this resource:
- Visit the MCG care guidelines web page. Read the declaimer and accept the terms and conditions.
- Complete the User Information form.
- Complete the verification process to continue.
- Select the arrow icon to expand the list of guidelines in the content group.
- Select the guideline you wish to view.
Please note because these are a protected intellectual property of MCG, this resource cannot be printed.
A note about correction requests: Providers can check prior authorization requests or the status of a correction request through the HPSM Provider Portal. The timeliness requirement for correction requests is 14 calendar days.