Practice Guidelines

Accountable Health Care, IPA (AHC) utilizes clinical practice guidelines as standards of health
care applicable to members and providers. The AHC Quality Management Committee performs
a review of nationally and locally developed guidelines and gives final approval of the adoption
of all guidelines.
All clinical practice guidelines are based on scientific evidence, review of the medical literature,
or appropriately established authority, as cited. All recommendations are based on published
consensus guidelines and do not favor any particular treatment based solely on cost
consideration.
The recommendations for care are suggested as guides for making Medical Necessity clinical
decisions. Clinicians and their patients must work together to develop individual treatment plans
that are tailored to the specific needs and circumstances of each patient.
Providers and members have the right to request a copy of a guideline that AHC has used to
make a treatment authorization decision.