The Utilization Management Program monitors, evaluates and manages the costs and quality of healthcare services delivered to customers of Community Health Partners. A local staff consisting of a medical director and a team of registered and licensed practical nurses review inpatient and outpatient procedures and services to determine medical necessity and cost-efficiency.

Program components include:

• Pre-admission and admission review.
• Concurrent hospital stay review.
• Case Management and Disease Management (SmartChoice).
• Referral authorization for a specialist or out-of network care.
• Outpatient service and ambulatory review.

For more information on Utilization Management and other medical services solutions from Community Health Partners, call 239.659.7770

Click the link below to fill out the Pre-certification request form and fax to 239.659.7785. Please make sure to attach supporting clinical information. 

Pre-cert Form - NCH Healthcare System 

Pre-Cert Form - CC Gov't, CC Schools, CC Sheriffs

Pre-Cert Form - Naples Gold Network

CCHC 2010Formulary Impact