Utilization Management

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​​The PHC Utilization Management (UM) program team serves to implement a comprehensive integrated process that actively evaluates and manages utilization of health care resources delivered to all members, and to actively pursue identified opportunities for improvement. The UM program serves our members by assuring that:

•  Members receive the appropriate quantity and quality of healthcare services
•  Service is delivered at the appropriate time
•  The setting the service is delivered in is consistent with the medical care needs of our members

Submitting Referrals and Authorizations

Please use our online system to submit Referral Authorization Forms (RAF) and Treatment Authorization Forms (TAR).

Click here to submit RAFs and TAR online

Treatment Authorization Request (TAR) Requirements

RAF/TAR Status

PHC's TAR/RAF inquiry system is available online.

Click here to check RAF and TAR status.

 

 

 

 

​Endocrinology Guidelines

 

Project Echo

PHC Endocrinology Referral Guidelines

PHC Webinar: Guidelines for Endocrinology Referrals

Slides | Recording