Access to Care Partners’ Access to Care Department is responsible for a 24 hour, seven days a week, 365-day a year behavioral health screening, triage, and referral service for citizens needing mental health, substance use, or intellectual and developmental disability services. All calls are answered live, in real time, by an Access to Care representative. […]
The Utilization Management (UM) Department ensures that individuals have equitable access to appropriate care across the Partners catchment area.
Partners works with a number of hospitals to provide inpatient services for enrollees. This section contains information for hospital providers.
Partners’ Utilization Management (UM) Department’s function is to make authorization decisions by conducting initial, continuing care and retrospective reviews of services based on whether medical necessity is substantiated in the request for authorization.
Clinical Criteria Check Sheets are used by Partners’ Utilization Management department to approve service authorization requests.