LifeWise offers access to more than 300 medical policies online. Since we’re continually updating these pages, we encourage you to visit often. The policies are in Adobe PDF format. To access our medical policies, please read and agree to the disclaimer statement.
LifeWise’s medical policies should be used as a guide in evaluating the medical necessity of a particular service or treatment. The Company adopts these policies after careful review of published and peer-reviewed scientific literature, national guidelines, and local standards of practice. Since medical technology is dynamic, The Company reserves the right to review and update policies as appropriate. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits.
Members and their providers will need to consult the member’s benefit plan to determine if there is any exclusion or other benefit limitations applicable to this service or supply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered for a particular member. The member’s benefit plan determines coverage. Some plans exclude coverage for services or supplies that are considered medically necessary.
When a service requires pre-service review, there isn't a penalty, but we'll hold the claim and ask for medical records.