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I. HMO Responsibilities

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HMO utilization management I. HMO A. HMO Program 2. B. Physician 3. C. HMO UM Staff ........................................ ........................................ ............................ 3. D. Program Scope ........................................ ........................................ .......................... 3. E. Program Goals ........................................ ........................................ ........................... 4. F. Clinical Criteria for UM Decisions ........................................ ....................................... 4. G. Requirements for UM Decision 4. H.

HMO Utilization Management BCBSIL Provider Manual—Rev 3/09 2 I. HMO Responsibilities A. HMO Program Structure Two health maintenance organizations exist within the managed care structure of Blue Cross and Blue Shield of

  Management, Responsibilities, Utilization, Utilization management, Hmo responsibilities

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