DCS Comprehensive Health Plan
Transplant Services
Policy No. |
Responsible Area |
Last Date |
Effective Revised |
|---|---|---|---|
|
|
Health Coordination |
08/31/2023 |
08/31/2023 |
Statement/Purpose
This policy outlines the requirements and criteria for determining medical necessity and appropriate care for transplant services covered by Department of Child Safety Comprehensive Health Plan (DCS CHP).
Authority
[Insert and link legal citations]
Definitions
[List definitions not commonly known that are specific to the policy]
Policy
[Policies are the guiding principles and/or rules that ensure consistency and compliance with DCS CHP’s mission, values and strategic goals]
Procedure
[Procedure are high-level actions that guide adherence to policy. Procedures describe the methods used to comply with policy]
References
[Insert and link referenced policies]
Related Forms
[Insert all documents, forms etc referenced within the policy] N/A
Reviewed and Revised Date (Month/Year) |
Reason for Review |
Revision Description |
|---|---|---|
|
02/2024 |
Annual Review |
Added updates based upon ACOM 103 revisions and updated reporting requirements. |
|
03/2022 |
Annual Review |
Added and revised pertinent information required for health plan integration. |
