Utilization Review

The Utilization Review Department, located at Morongo, handles Contract Care External Referrals. The referrals start with your provider. He/She then sends the referral to the UR Department. If it is an emergency or urgent referral, your provider will call the Chair of the UR Department and discuss this referral with them. The referral is then set up as quickly as possible. The routine referrals take approximately 2-3 weeks to process. They are reviewed by the UR Committee and then processed if approved.

If you do not hear from the UR Department on the status of your referral within a few weeks of your provider visit, please call the UR Department at Morongo to discuss it. You can receive a status update. There are instances when the referral has been deferred due to lack of information or work up. There are other times when the referral is not a covered benefit and needs to be re-addressed with your provider.