Clinical policies for providers

Geisinger Health Plan (GHP) uses medical policies as guidelines for coverage decisions made within the insured individuals written benefit documents. Coverage may vary by line of business and providers and members are encouraged to verify benefit questions regarding eligibility before applying the terms of the policy. These medical policies were developed to assist participating providers in administering and understanding the provision of benefits.

What’s new?

See the latest updates to our policies and medical information.

Current medical policies

View the latest updates to our medical policies.

Pharmaceutical policies

See updates to our medical benefit pharmaceutical policies.

For information regarding medical and or/medical benefit pharmaceutical policies, contact:

Medical Policy/Clinical Guidelines
Geisinger Health Plan
100 N Academy Ave
Danville, Pa 17822-3234
medicalpolicies@thehealthplan.com
800-544-3907, option 2

Give us your feedback

Medical benefit policies are developed using resources such as our Technology Assessment Committee, currently contracted independent technology assessment vendors, current peer-reviewed, published medical literature reviews, plan medical directors, pharmacists, and physician consultants/experts.

The policies are reviewed annually, or sooner if new and compelling data necessitates earlier review. Participating providers are encouraged to submit input (supported by published literature) regarding these policies at any time.

Comments and supporting documentation can be submitted through the below form or by mailing to:

Geisinger Health Plan
Manager, Medical Policy/Clinical Guidelines
100 N Academy Ave.
Danville PA 17822-3220

Related information

Learn more about Geisinger Health Plan.

Questions? Contact us

If you have questions or need more information, contact Geisinger Health Plan.

Clinical guidelines

Clinical guidelines offer providers consistent and appropriate guidance for diagnosis and treatment of specific conditions or diseases.

Prior authorizations

Log in to NaviNet to access and view prior authorization information.

Health and wellness

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