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2008 Clinical Practice and Behavioral Guidelines
The 2008 Clinical Practice Guidelines (CPGs), are adopted by Blue Cross and Blue Shield of Texas (BCBSTX), and are the foundation for the Condition Management Programs. The CPGs are updated at least every two years or more frequently, as needed. The link below provides information about the CPGs. You may request a hard copy of the CPGs by calling BCBSTX at 1-866-412-8795 and asking for the Condition Management department. If you would like to comment on the CPGs adopted by Blue Cross and Blue Shield of Texas, contact Dr. Allan Chernov, Medical Director, 901 S. Central Expressway, Richardson, TX 75080. Phone number for Dr. Chernov is 972-766-1149.
Clinical Practice Guidelines
Clinical guideline references are available for the following conditions:
- Asthma
- Chronic Obstructive Pulmonary Disease
- Coronary Artery Disease
- Chronic/Congestive Heart Failure
- Diabetes
- Hypertension
- Low Back Pain
- Metabolic Syndrome
- Oncology
- Lifestyle Management Programs as part of the Blue Care Connection® Program
The Blue Review provider newsletter features articles regarding the availability of the nationally recognized CPGs as well as the BCBSTX Condition Management Programs. The Condition Management Programs offered by BCBSTX include asthma, chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, diabetes, hypertension, metabolic syndrome, oncology, and low back pain. These programs are offered by BCBSTX to selected HMO's, all Fully Insured members and the selected PPO/POS members whose employer group has purchased the programs. If you have a patient who you feel would benefit from one of the above mentioned programs, please call 1-866-412-8795 to enroll them today.
Behavioral Health Guidelines
BCBSTX, working with the Behavioral Health vendor, Magellan Behavioral Health, Inc.TM, have adopted the following American Psychiatric Association clinical practice guidelines:
Copies of these guidelines may be viewed below. Printed copies may be ordered through the American Psychiatric Publishing, Inc. (APPI) at www. appi.org, or by calling (800) 368-5777, or by U.S. mail at: American Psychiatric Publishing, Inc., 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209-3901.
In addition to the APA, the Practice Guideline for the Treatment of Patients with Schizophrenia was adopted to be used with the Texas Implementation of Medications Algorithms (TIMA) Guidelines for Treating Schizophrenia, Physician Procedural Manual (last edited November, 2001).
Copies are available through the Texas Department of Mental Health and Mental Retardation
The Clinical Practice Guideline for Assessing and Managing the Suicidal Patient (2002), developed by Magellan Behavioral Health, Inc. has also been adopted by BCBSTX and is available below.
If you would like a hard copy of the clinical practice guidelines, you may contact the BCBSTX Quality Improvement Programs Department at 1-800-863-9798.
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