Utilization Management Criteria

Utilization review decision criteria are made available to practitioners, members and the public upon request. Group is only required to disclose the criteria or guideline for the specific procedures or conditions requested. Please call South Atlantic Medical Group’s UM department at (323) 725-0167 or for the hearing impaired, please call TTY at 711, Monday through Friday 9:00am- 6:00pm and ask for any staff member for a copy of criteria. Criteria can also be read over the phone.