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Coverage Policy Bulletins are for informational purposes only and should not be relied upon in the diagnosis and treatment of individual patients. They do not constitute medical advice, plan pre-authorization, certification, explanation of benefits, or a contract for services. Coverage Policy Bulletins are written as a resource and based upon review of medical literature and common medical practices in the diagnosis and treatment of disease. Because medical practices and knowledge are constantly changing, WPS Health Plan, Inc. reserves the right to review, change, and enhance Coverage Policy Bulletins as we deem appropriate. The conclusion that a particular service, treatment or supply is medically necessary does not represent or warrant that this service, treatment or supply is covered. All covered expenses are subject to the terms and provisions, as well as, the limitations and exclusions described in a member's plan. Expenses for which no benefit is specifically described in the member’s plan are not considered a covered expense. Eligibility and benefits are determined by the member’s plan contract that is in effect at the time that a service is provided. By clicking OK, you agree that WPS Health Plan, Inc. will not be liable for any claims, lawsuits, settlements, judgments, costs, penalties and expenses, including, but not limited to, attorneys' fees, court costs, or other legal expenses resulting from or arising out of your use or reliance upon information contained in any or all Coverage Policy Bulletins.

 


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