A process in which a managed care plan decides if an enrollee should get health care that their doctor has requested, or if the plan should pay for care that the enrollee has already received. Utilization review decisions should be made by doctors that work for the plan.
CHA can help answer your healthcare questions.
- Call our helpline at (888) 614-5400 Monday to Friday, 9am to 4pm,
- or email firstname.lastname@example.org.