Utilization Management

Prior Authorization Review is a process of reviewing certain medical, surgical, and behavioral health services to ensure medical necessity and appropriateness of care prior to services being rendered.

• Pre-existing condition overview for clinic staff
• 2007 Quick Glance List of Services Requiring Medical Necessity Reviews
• Prior Authorization Criteria
• Imaging Studies no longer requiring Prior Authorization
• Routine Care and Screening Guidelines
• Authorization for Release of PHI
• 2008 Prior Authorization List
• 2008 Prior Authorization Form

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