Utilization Management Procedures

Utilization Management (UM) helps us work with your doctors to give you the right care, at the right time, and in the right setting.

How Do I Request a Review?

To start the review process, call us at 1-800-851-3379 (TTY 711).

Preservice Review

A preservice review is when we review our coverage of medical care or services before you get that care. Care and services that require this approval are in your policy, or you can log in to Your Health Alliance.

Urgent Concurrent Review

An urgent concurrent review is when we review our coverage of medical care or services while you're in the process of receiving that care, even if it was not approved before you started receiving the service.

Postservice Review

A postservice review is when we review our coverage of medical care or services that you've already received.

Appeals

If you have a complaint or are unhappy with coverage for care or a service being denied, in certain situations, you have the right to file an appeal.

To Start an Appeal

  • Call us at 1-800-500-3373
  • Fax us at 217-337-8009
  • Mail us your appeal in writing to:
     
    ATTN: Member Relations
    Health Alliance
    3310 Fields South Drive
    Champaign, IL 61822