Policies, Guidelines and Manuals
HealthKeepers, Inc. is committed to supporting you in providing quality care and services to the members in our network. Find information on member benefits, program requirements, Utilization Management (UM) guidelines, clinical practice policies and other resources for providing care to our members.
Provider manual
The Anthem HealthKeepers Plus Provider Manual is your key source for information about covered benefits, case management and UM programs, claims and appeal guidance, authorization requests, and other program requirements.
Clinical practice guidelines
HealthKeepers, Inc. considers Clinical Practice Guidelines (CPGs) an important component of healthcare. We’ve adopted nationally recognized CPGs and encourage providers to use these guidelines to improve members’ health.
Medical policies and clinical UM guidelines
Medical Policies outline the medical necessity requirements of certain services or procedures, including new applications of these services. Clinical UM Guidelines focus on detailed selection criteria, goal length of stay, and location for generally accepted technologies or services.
Related information
- February 2021 Clinical Utilization Management (UM) Guidelines
- Anthem CCC Plus Quick Reference Guide
- Child Community Mental Health and Rehabilitation Services (CMHRS) UM Guideline
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Behavioral Therapy Program UM Guideline
- General Community Mental Health Rehabilitation Services (CMHRS) UM Guideline
- Virginia Medicaid Peer Support Services UM Guideline
- February 2020 Clinical Utilization Management (UM) Guidelines
- May 2020 Clinical Utilization Management (UM) Guidelines
- August 2020 Clinical Utilization Management (UM) Guidelines
- November 2020 Clinical Utilization Management (UM) Guidelines
