Ohio Medicare Advantage and Dual Special Needs Populations (DSNP) Laboratory Testing Policies

These laboratory testing policies apply to all CareSource Medicare Advantage and Dual Special Needs Populations (DSNP) plans. These CareSource policies are published by Avalon Healthcare Solutions on behalf of CareSource.

These policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are subject to all the terms and conditions of CareSource including eligibility, definitions, specific inclusions or exclusions, and applicable state or federal laws. Policies are considered guidelines and are not intended to infer benefits or coverage for a specific member. 

Policy Hierarchy

Decision making for Medicare Advantage and Dual Special Needs Populations (DSNP) plans is based upon the following hierarchy: 

 

Register for the July Webinar: Value-Based Care Meets Patient-Centered Care for Lab Testing

Tuesday, July 19
2:00 PM – 3:00 PM EDT

Connect With Us

Want to get in touch? We’d love to hear from you.