Authorization

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.

Pre-certification/Pre-Determination Form

Please enter your company name or group number below to obtain contact information for authorizations and pre-certifications.