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Utilization Management Information
- Upon request, you may obtain a free copy of the actual benefit provision, guideline, protocol, or other similar criteria on which an approval or denial decision was based by calling Arizona Priority Care at (480) 499-8720 (TTY 711).
- Additionally, any Provider may contact the Physician who reviewed any specific approved or denied referral determination directly by calling (480) 499-8720 (TTY 711).
- Business hours: Monday to Friday – 8:00 AM to 5:00 PM
Affirmative Statement About Incentives
- Utilization Management (UM) decision-making is based only on the appropriateness of care and service existence of coverage
- The organization does not specifically reward practitioners or other individuals for issuing denials of coverage or service care
- Financial incentives for UM decision-makers do not encourage decisions that result in under-utilization