Medical Policy

UniCare's Utilization Management (UM) program identifies opportunities for improvement in care through our pre-certification, continued stay review and case management processes. Our UM benefit program promotes quality outcomes with the goal of improved health status and increased member satisfaction.

UniCare makes benefit decisions only in accordance with the member's certificate of coverage. Decisions about whether any medical service is covered are not the provision of medical care. The final decision about what medical care is rendered is between the physician and the patient.