Administrative Manual

Our Administrative Manual applies to physicians, other health care professionals and facilities.

Our manual contains medical policy and procedure information that can be used as a day-to-day reference by our providers and their staff.

Dentists and dental professionals should visit asurisdental.com for the CDT Guide or Dental Manual and Guidelines.

Notification of content changes

Updates to manual sections are posted at the beginning of the month in which they occur and a notification is included in our newsletter, The Connection℠. Our newsletter is published in February, April, June, August, October and December. Sign up to receive our newsletters via email. Please review new content promptly to ensure you have the most current information.

Learn more about us, view our Code of Business Conduct policy or our confidentiality information and requirements.

Section	Revision date	Change
Introduction (PDF)	6/2024	Clarified medical record request requirements and updated references to provider website
Appeals for Members (PDF)	3/2021	Added link to member authorization to disclose information
Appeals for Providers (PDF)	10/2023	Replaced outdated mailing addresses with paths to information on the provider website Updated references of our Fraud and Abuse department to our Special Investigations Unit
Alternative Care (PDF)	6/2024	Clarified that not all member plans require a prescription for massage therapy
Facility Guidelines (PDF)	10/2024	Revised reference to Surgical Site of Care - Hospital Outpatient (Utilization Management #19) medical policy
Fraud and Abuse (PDF)	8/2019	Updated hyperlinks throughout Updated name of anti-fraud department to Special Investigations Unit (SIU)
Laboratory (PDF)	2/2022	Revised the Documentation Requirements section
Medical Management (PDF)	8/2023	Added nuclear medicine imaging to the list of services included in our radiology program
Medical Record Requirements (PDF)	6/2024	New section to clarify and outline requirements for medical records documentation and signature authentication in alignment with CMS rules
Medicare Advantage Plans (PDF)	4/2024	Added Cultural Competency requirements
Medicare Advantage Compliance Requirements (PDF) Note: Our Medicare Advantage providers must comply with the requirements in this section, in accordance with the Medicare Advantage Provider Compliance Addendum.	4/2022	Updated regulatory references
Policies (PDF)	11/2023	Removed dental-related content and added information that dental providers can now find tools and resources on asurisdental.com/providers Updated the description of The Bulletin
Provider and Facility resources (PDF)	11/2023	Removed dental-related content and added information that dental providers can now find tools and resources on asurisdental.com/providers Updated the description of The Bulletin Updated the list of medical policy information
Qualified Health Plans (PDF)	12/2020	Added this new section that includes the requirements for providers who care for members on our Individual and small group products
Risk Adjustment (PDF)	4/2022	Added information about provider education
Therapy (PDF)	4/2023	Updated treatment plans section