Select Health Policies

Policy Development

Select Health medical, dental, and coding/reimbursement policies represent our determination of whether services or devices are standard medical practice, experimental/investigational, cosmetic, or within coding standards. NOTE: By accessing and/or downloading Select Health policies, you automatically agree to the Medical and Coding/Reimbursement Policy Manual Terms and Conditions.

Pharmacy Policies

• View pharmacy policies state by state and by drug here. 
• Use PromptPA to obtain preauthorization for prescriptions and infusible drugs and to see pharmacy coverage requirements.
• To submit a pharmacy-related appeal, please follow this simple process:
  • Step 1: Access the online appeals form.
  • Step 2: On the appeals form, be sure to select plan, fill in required fields, and attach supporting documentation (if necessary).
  • Step 3: Click the submit button at the bottom right of the form. 

Policy Resources

• Latest Select Health Monthly Policy Update Bulletin
• Policy Update Bulletin Archive
• FDA Overview of Device Regulation
• InterQual® Criteria