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The Care Guidelines span the continuum of care, providing access to evidence-based knowledge and best practices relevant to patients in a broad range of care settings. This not only assists with decisions for each setting, but also facilitates coordination of care and smooth patient transitions.
The series includes: Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, Chronic Care Guidelines and Behavioral Health Guidelines. Closely interrelated, they provide a basis for efficient organization of care across the entire spectrum of healthcare delivery.
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Important Information About the Milliman Care Guidelines: The Care Guidelines can be used by qualified, healthcare professionals as a tool in making medical necessity decisions, but they should not be used as the sole basis for denying coverage of payment. The Care Guidelines must be applied to the individual patient on a case-by-case basis and always in the context of a qualified, healthcare professional’s clinical judgment.