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Forms and Policies

These are our forms and policies.
Click the Download buttons below to see each form and policy.

Forms and Policies

General
Recommendations for Preventive Pediatric Health
Medical Policies
Recreational Therapy Policy
Medical Policies
Scenesse (afamelanotide)
Prior Authorization
Services Requiring Prior Authorization 2024
Medical Policies
Site of Care Policy
General
Telehealth Policy
HIPAA
The Ohio State University Health Plan Notice of Privacy Practice
Medical Policies
Tobacco Cessation Program Policy
Appeals
Treating Physician Certification – Internal/External Appeal