Geisinger Health Plan® - Medical Policies for Health Care Providers

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Medical Benefit Policies

You will need to login as a Provider or Provider Office to view the Medical Policies.

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By continuing to the medical policies, I acknowledge receipt of the following information:
•  The medical policy is not an authorization, certification, explanation of benefits or a contract.
•  Specific limitations, exclusions, coinsurance and/or exceptions in the member's contract will supercede the medical policy.
•  Coverage may vary by line of business. Providers and members are encouraged to verify benefit questions regarding eligibility before applying the terms of the policy.
•  Unless otherwise specifically excluded, government mandates will apply to all plans.
•  For members enrolled in the Gold line of business, these policies will apply unless CMS guidelines extend coverage beyond them.

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.

Contact Us

Plan providers are encouraged to submit input (supported by published literature) regarding these policies at any time.

Comments and supporting documentation can be forwarded:

Online:
medicalpolicies@thehealthplan.com
Or Mailed To:
Manager, Medical Policy/Clinical Guidelines
Geisinger Health Plan
100 N Academy Ave.
Danville PA 17822-3220

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Contacts for Provider
Network Management

If you have questions or need information, please contact your Geisinger Health Plan provider relations representative at the number listed.

Danville:(800) 876-5357

Harrisburg: (888) 281-5338

Scranton: (800) 350-6486

State College: (888) 669-4834