Clinical Guideline Resources

Clinical Review Criteria

Useful Websites

Alcohol and Substance Use Disorders

Appropriate Antibiotic Use



Chronic Obstructive Pulmonary Disease (COPD)





Potentially Inappropriate Medication Use in Older Adults

Preventive Care

Tobacco Use

Weight Management

Clinical Guidelines Resources have been developed to assist patients and providers in choosing appropriate healthcare alternatives for specific clinical conditions. Guidelines were developed by nationally recognized organizations and are evidence based. While clinical practice guidelines are useful aids to assist providers in determining appropriate care practices for many of their patients with specific clinical problems or prevention issues, the guidelines are not meant to replace the clinical judgment of the individual physician or establish a standard of care. Note, recommended services in association with the clinical guidelines are not a direct reflection of insurance coverage. Coverage for services is subject to the limitations specified in the member's benefit plan.

The recommendations contained in the guidelines may not be appropriate for use in all circumstances. Decisions to adopt any particular recommendation must be made by the provider in light of the circumstances presented by the individual patient. Accordingly, your health plan
 makes and receives no warranty, express nor implied, and all warranties of merchantability and fitness for a particular purpose are expressly excluded