Milliman Care Guidelines®

To promote quality care, patient safety and the most appropriate use of healthcare resources, Moda Health utilizes the evidence-based Milliman Care Guidelines® for:

The Milliman Care Guidelines are developed using the industry’s most rigorous evidence-based methodology. All content is reviewed annually and updated as necessary by doctors and nurses who cite more than 15,000 unique references, including peer review journals in the current seven-product Care Guidelines series. Milliman Care Guidelines epidemiologists then examine databases that cover a significant portion of the United States population to validate that these published research results are achievable in real-life situations.

The adoption of these new guidelines will not affect your process for notifying Moda Health of admissions or for seeking prior authorization approval. Those phone calls should still be directed to the Moda Health Medical Intake Unit at 503-243-4496 or toll-free at 800-258-2037. Moda Health will continue to use the focus list of services requiring prior authorization.

If you have any additional questions about these changes, please call our Medical Customer Service department at 503-265-2964 or toll-free at 888-217-2363. You also can review the Milliman Care Guidelines online at www.careguidelines.com.

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Hello.

We have exciting news to share. ODS is changing its name to Moda Health.

Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.

Together, we can be more, be better.

Please select the state you live in, or the state where your employer is headquartered, so we can tailor your experience:

Hello.

Please select the state you live in, or the state where your employer is headquartered, so we can tailor your experience:

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