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This article is intended for HMO members enrolled in an employer health insurance plan.
Utilization management (UM) is a tool that helps Blue Cross and Blue Shield of Illinois determine whether you are getting appropriate care. UM decisions are based on medical need. That includes whether your care, services and benefits are right for you.
Your Medical Group/Independent Practice Association (IPA) provides access to staff for members who want information about the UM process and the authorization of care. These services are provided for members:
The more information you have about your medical care, the better you can manage your care. Using the resources available to you can help.
If you have questions, call the customer service number on your member ID card.
Originally published 7/2/2020; Revised 2021
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