Clinical Guidelines

Heritage Sierra Medical Group (HSMG) uses leading industry proven Clinical Guidelines to review authorization requests for medical necessity. The Clinical Guidelines are the protected intellectual property of the vendor and cannot be distributed. However, we have provided a tool that allows our providers, members and prospective members to view relevant guidelines.

The materials provided to you are guidelines used by the plans to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract.

To access the Clinical Guidelines, please click on the link below:

https://www.heritageprovidernetwork.com/?p=clinical-guidelines