Guideline/Procedure Number: : External Policy Guideline/Procedure Title: Internal Policy : Original Date: : Applies to: Medi-Cal ☒ Employees OPerations Executive Compliance Department BOARD COMPLIANCE FINANCE PAC CEO COO Credentialing DEPT. DIRECTOR/OFFICER : : : MCUP3037 - Appeals/ Expedited Appeals of UM Decisions for Medical Necessity Determination (NonAdministrative) MCUP3041 - TAR Review Process MCUP3124 Referral to Specialists (RAF) Policy – MPUG3045 - Utilization Management Guidelines Case Management – MCUG3058 - Utilization Review Guidelines ICF/DD, ICF/DD-H, ICF/DD-N Facilities MPUP3078 Second Medical Opinion – MCUP3138 External Independent Medical Review – MPUD3001 - Utilization Management Program Description : Health Services Claims Member Services Provider Relations :
Guideline/Procedure Number: : Guideline/Procedure Title: External Policy Internal Policy Original Date: : : Applies to: ☒ Medi-Cal Employees OPerations Executive Compliance Department BOARD COMPLIANCE FINANCE PAC CEO COO Credentialing DEPT. DIRECTOR/OFFICER : : : MCUP3037 - Appeals/ Expedited Appeals of UM Decisions for Medical Necessity Determination (NonAdministrative) MCUP3041 - TAR Review Process MCUP3124 – Referral to Specialists (RAF) Policy MPUG3045 - Utilization Management Guidelines – Case Management MCUG3058 - Utilization Review Guidelines ICF/DD, ICF/DD-H, ICF/DD-N Facilities MPUP3078 – Second Medical Opinion MCUP3138 – External Independent Medical Review MPUD3001 - Utilization Management Program Description : Health Services Claims Member Services Provider Relations :