Medical Management

The Medical Management (MM) program consists of ongoing authorization and coordination of each member's care.

  • Purpose: Serve as the member's advocate to facilitate and implement equal access to medical care for each member.
  • Span: Inclusive of both the inpatient and outpatient settings of medical health care.
  • Core Function: Evaluate the appropriate allocation of resources based on medical necessity.
  • Scope: Ensure that each medical management function is structured to ensure consistent and prompt decision-making.

You may call Medical Management at (888) 327-0671 or (810) 733-9722 if you would like to speak with the Chief Medical Officer about a utilization denial or any utilization issue.