Three Rivers Medical Management provides client-specific utilization management solutions for self-funded employers. These services include: precertification of Inpatient & outpatient services, concurrent review, discharge planning, network steerage, large case management and independent medical review. TRMM uses evidence-based guidelines to guide medical necessity determinations. Non-certification decisions are made by physicians.
Physician Reviewers are board-certified & hold current medical licenses. Nurse case managers are CCM's [Certified Case managers]. Case managers who have earned the Certified Case Manager (CCM ®) credential have the expertise, knowledge, and professional experience to provide the right services to patients across the continuum of care, including those with serious or complex medical conditions, and/or catastrophic injuries and illnesses.
Please note: the above pre-certification/pre-determination form is ONLY to be used on accounts in which TRMM is the precert company. This form is NOT to be used for CHS Group Health Plan. Please contact Quantum at 877-986-8136 for their precert form.
Please enter your company name or group number below to obtain contact information for authorizations and pre-certifications.