Utilization Management Policies
Procedures and Criteria are disseminated to members and providers upon request by calling our Customer Service department at (877) 282-8272 Opt. 1, Monday through Friday between 9:00 AM to 5:00 PM PT. For the hearing impaired, please call our TTY telephone at 877-735-2929, Monday through Friday between the hours of 8:30 AM to 5:00 PM PT.
A requesting practitioner may call Network Medical Management to discuss a denial, deferral, modification, or termination decision with the physician (or peer) reviewer at (877) 282-8272 ext. 6195; Monday through Friday between the hours of 9:30 AM to 2:30 PM PT. All calls will be returned within 24 hours.