Utilization Management

Did you know that CCPN has a Utilization Management Department dedicated to assisting you with inquiries you may have regarding referrals to specialists or any other provider required to address your healthcare needs? The staff in the Utilization Management Department will review the recommendations of your Primary Care Physician (PCP) or Specialist and ensure you receive the most appropriate medical care, from the most appropriate provider based on your individual health care requirements.

The Utilization Management staff is available to assist you telephonically by calling 1(800)763-7732, Monday through Friday, 8:00am-5:00pm.

CCPN requires that physicians and health care professionals make medical decisions based on member's medical needs.  We do not compensate anyone for denying coverage or service, and we do not use financial incentives to encourage denials of any needed medical service.  To prevent inappropriate decision making CCPN monitors for under and over utilization by analyzing data to identify causes and then takes actions to correct any instances of potential of actual under or over utilization.

Hours of Operation


TDD/TTY users should call 711

2020 Utilization Management Program