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Provider Type

  • Physicians
  • Hospitals
  • Participating Physician Groups (PPG)
  • Ancillary

Health Net's utilization management (UM) program is designed to ensure that members receive timely, medically necessary and cost-effective health care services at the correct level of care. The scope of the program includes all members and network providers. Prior authorization, concurrent review, discharge planning, care management, and retrospective review are elements of the UM process.

Last Updated: 07/04/2024