Affirmation Statement
Affirmation Statement
West Regional Physicians, IPA "WRP IPA"
Utilization Management (UM) decision making is based only on the appropriateness of care and service and the existence of coverage. WRPN IPA does not specifically reward practitioners or other individuals for issuing denials of coverage or service care.
WRPN IPA does not offer financial incentives to UM decision-makers that encourage decisions that result in underutilization.
Our practitioners are ensured independence and impartiality in making referral decisions that will not influence hiring, compensation, termination, promotion any other similar matters.
Utilization Management
Members and Provider may request a copy of the criteria used in the decision-making process by calling the number listed below:
Fax: (323) 489-3220
Via TDD/TTY
Call the TTD/TTY number on your Member ID card or dial 711 for Telecommunications Relay Service
UM Communications
Utilization Management Staff is available from 8:00 am –5:00 pm Monday through Friday to answer Member and Provider questions related to the authorization and referral processes. An After-Hour nurse is available after 5:00 pm to assist Members after normal business hours, Weekends and Holidays.
Members and Providers may request a copy of the criteria used in the decision-making process by calling us at (844) 691-5860 or fax request to (323) 489-3220. For the hearing impaired, call the TTD/TTY number on the back of your Member ID card or call 711 for Telecommunications.