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Health Care Management reviews

Our Health Care Management unit offers a staff of dedicated licensed, certified registered nurses available to assist our members in accomplishing the best possible outcomes.

Some of the services HCMU provides:

HCMU is responsible for review of all requests for life insurance requiring a Life Insurance Application.

HCMU reviews all applications for disabled dependent status.

If you have any questions concerning this process, please contact our office at 405-717-8879 or toll-free 800-543-6044, ext. 8879.

Specialty services include but are not limited to emergencies and services not available within our network.

Emergency rule:

Members may have additional benefits available for medical emergencies when non-network services occur.  This benefit is available only upon request. You must notify a case manager at HealthChoice by calling toll-free 800-543-6044, ext. 8879 for consideration.

Services not available in network:

In the event a member requires services not available in network, additional benefits may be allowed only with prior approval through HCMU. Please contact our case managers toll-free at 800-543-6044, ext. 8879 or, in the Oklahoma City metro area, 405-717-8879.

HealthChoice is licensed by the Oklahoma Insurance Commission to provide utilization review services. Our Utilization Review Plan is updated on an annual basis to reflect changes in policies and procedures.

This plan also addresses provider and member concerns relating to utilization and quality issues. To discuss any concerns, please contact our office at 405-717-8879 or toll-free 800-543-6044, ext. 8879.

Last Modified on Aug 08, 2021
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