Clinical Criteria used for Review
Members may obtain a free-of-charge copy of the specific benefit provision, guideline, protocol, or other similar criteria used in an authorization decision by downloading this document or by contacting Hill Physicians Medical Group Customer Service at 1-800-445-5747.
MCG (Milliman Care Guidelines) link to look up your criteria:
If your authorization decision mentions MCG as the criteria and you would like to review this, yourself, to see the details that were used for the authorization decision, please click here.
Hill Physicians Medical Group utilizes the Care Guidelines to determine medical necessity for the plans that we manage. The Guidelines are the protected intellectual property of MCG. Hill Physicians Medical Group is not able to distribute them without the permission of MCG. MCG has provided a tool that allows Hill Physicians Medical Group members and prospective members to view relevant MCG guidelines, however you will not be able to print them.