Utilization Management is a systematic, proactive process used to review medical treatment request from medical providers and determine whether the requested treatment protocol or services are appropriate and medically necessary for the injured worker. Reviewers use evidence-based medical guidelines in their decision-making processes, ensuring injured workers receive appropriate care, at the appropriate level, and time.

In keeping with its commitment to quality services, Promesa Health's Utilization Management Department is accredited by URAC®, an independent, nonprofit organization dedicated to promoting the quality and efficiency of health care management through accreditation, education, and measurement.

Please click here to view the California Utilization Review Plan.