Welcome to our Utilization Management and Program Criteria page. Here, you’ll find essential information about how we ensure that our services are used effectively and align with our program standards.
Welcome to our Utilization Management and Program Criteria page. Here, you’ll find essential information about how we ensure that our services are used effectively and align with our program standards.
Our Utilization Management program is designed to optimize the quality of care while controlling costs. Through UM, we assess the necessity, appropriateness, and efficiency of healthcare services and procedures. This process involves:
Our program criteria outline the specific standards and guidelines used to evaluate healthcare services. These criteria are developed based on:
Effective utilization management helps:
For more details or to submit a request for review, please contact our Utilization Management department or use our online portal. We are committed to providing the highest level of care while ensuring efficient and responsible use of resources.
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