Practice Guidelines & Preventive Health Guidelines

Care1st utilizes practice guidelines, criteria, quality screens and other standards for certain areas of medical management, disease management, and preventive health. Our guidelines follow nationally accepted standards and are reviewed and approved by our Medical Management Committee, which is comprised of both clinical staff and network physicians. Updates occur annually or more frequently if needed. If you have questions on our guidelines or would like a hard copy of our guideline mailed to your office you may contact Provider Network Operations at 602-778-1800

Practice Guidelines

• Dysphagia and Assessing Risk of Aspiration and Choking
• HIV Guidelines
• HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C
• Pressure Ulcers in the Developmentally Disabled
• "The Fatal Four" Part Two--Dehydration
• High Blood Pressure

Screening Tools

• Depression
• PHQ
• PHQ-A
• PHQ-2
• Anxiety
• GAD-7
• Trauma
• ACES
• Substance Use
• CAGE
• DAST
• SBIRT
• Suicide Risk
• C-SSRS
• Social Determinants of Health (SDOH)
• PRAPARE

Tool Kits

• Tool Kit Adult ADHD
• Tool Kit Adult Depression
• Tool Kit Anxiety
• Tool Kit Child ADHD
• Tool Kit Child Anxiety
• Tool Kit Child Depression
• Tool Kit Management of Adult Postpartum Depression
• Tool Kit Social Needs Screening

Preventive Guidelines

• Refusal to Vaccinate
• EPSDT Periodicity Schedule
• Dental Periodicity Schedule
• Childhood & Adult Immunization Schedules

Pain Management Guidelines

• Opioid Treatment Guidelines
• Use of Chronic Opioid Therapy in Chronic Non-cancer Pain issued by The American Pain Society in Conjunction with The American Academy of Pain Medicine. Full report
• New National CDC Guidelines for Prescribing Opioids for Chronic Pain

Clinical Coverage Guidelines

• HS-301 - Behavioral Health Residential Facilities (BHRF)

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Disease Management Guidelines | Prior Authorization Guidelines & Criteria