Important information about utilization management
You can request a free copy of our UM criteria from our Medical Management department. Providers can discuss a UM denial decision with a physician reviewer by calling us toll free at 888-831-2246, option 4. To access UM criteria online, go to https://www.anthem.com/ca/provider/policies.
We are staffed with clinical professionals who work with you to coordinate our members’ care. Our staff will identify themselves by name, title, and organization name when initiating or returning calls regarding UM issues.
You can submit precertification requests 24/7 by:
- Calling: 888-831-2246, option 3 (includes both inside and outside L.A. County).
- Faxing a Pre-Service Review form to 800-754-4708 (includes both inside and outside L.A. County).
Have questions about utilization management?
Please call one of our Medi-Cal Customer Care Centers toll free at 800-407-4627 (TTY 711), or 888-285-7801 (TTY 711) for members in Los Angeles, Monday to Friday, 7 a.m. to 7 p.m.
November 2022 Anthem Blue Cross Provider News - California