Clinical Guidelines & Criteria
Native Advantage uses established clinical criteria to support consistent and appropriate healthcare decision-making. Detailed criteria are maintained in the applicable approved clinical resource rather than reproduced on this website.
Access clinical criteria
The InterQual link is pending. Contact Provider Services for help with applicable clinical criteria while online access instructions remain unavailable.
How to use these resources
Clinical decision support
Clinical criteria help support consistent review of applicable healthcare services.
Current criteria
Contact Provider Services for guidance on current criteria while the InterQual link is pending.
Plan requirements
Download the Provider Manual for plan requirements, or contact Provider Services for assistance.
Provider resources
For related provider information, visit the Provider Resources page or contact Provider Services.