Alaska Teamsters-Employers Welfare and Pension Trusts Home Page Alaska Teamsters-Employers Welfare and Pension Trusts Home Page
Clear explanations and comparisons of your health benefits
Online health forms
Find providers in your area
Frequently Asked Questions and Answers
Online summary plan booklet
Useful health related sites
Clear explanations and comparisons of your pension options
Online pension forms
Frequently Asked Questions and Answers
Online summary plan booklet
Helpful, categorized retirement links
Online Guide to Life Events
An index of site contents
Information about the Trusts
Alaska Teamsters-Employers Welfare and Pension Trusts Home Page
 
Alaska Teamsters-Employers Welfare and Pension Trusts Home Page
     Home → Welfare→ SPD → 6.2 ADMINISTRATION OF THE UTILIZATION MANAGEMENT PROGRAMS


6.2 ADMINISTRATION OF THE UTILIZATION MANAGEMENT PROGRAMS

The Plan’s utilization management program is administered by a Utilization Management Organization. The
health care professionals at the Utilization Management Organization focus their review on the necessity and appropriateness of Hospital stays and the necessity, appropriateness and cost-effectiveness of proposed medical or surgical services.

The Utilization Management Organization determines if a course of care or treatment is Medically Necessary.

The Utilization Management Organization certifies the Medical Necessity of proposed treatment. The Utilization Management Organization does not guarantee that a Participant is eligible for Plan benefits when services are received. Call the Trust Customer Service Office for questions regarding eligibility.


 

 
Features:
Search Site:
©Alaska Teamster-Employer Service Corporation, 2002-2006, powered by MultiEmployer.com