Many of the HNS policies were developed by our CQI Committee, in conjunction with our managed care partners, and were developed to assist you in meeting the high standards in documentation, coding and compliance established for all healthcare professionals. It is not our objective to establish numerous or unnecessary rules and policies for our network providers, rather, to provide you with written policies that should be consistently followed to help you maintain the high standards that must be met by all participating providers and to help you protect your practices. Many HNS policies and payor corporate medical policies are listed in the blue box on this page. Please click on the appropriate heading to review some of these policies. Other HNS and payor policies can be found in the HNS Protection Plan under the Provider Tab on this website.
HNS Contracted Payor Policies
HNS is an intermediary between the contracted payors and the providers in our network and HNS providers must adhere to all policies established by the insurers and PPO's that you represent as a participating provider.
For ALL services provided and billed through HNS, the medical necessity for the services must be clearly documented in the patient's health care record and must be consistent with the patient's chief complaint, clinical findings, diagnoses and treatment plan.
All services provided and billed through HNS must be consistent with all HNS and HNS contracted payor policies, the policies of applicable state licensing boards as well as state and federal laws.
HNS providers must comply with all HNS and payor policies provided they do not conflict with any state or federal requirements. However, these policies should not be followed if doing so could adversely affect the delivery of appropriate patient care.
ADL Forms 
