RE: Announcing our new Utilization Management (UM) Software System
TO: All MetroPlusHealth Providers
IMPACTED PLANS: Partnership in Care (PIC) HIV-SNP
MetroPlusHealth is excited to announce we are transitioning to a new internal Utilization Management (UM) software system. We will implement this new platform within the Partnership in Care (PIC) HIV Special Needs Plan (HIV-SNP) line of business later this year (expanding to our other lines of business in 2026).
This upgraded system will allow us to fax requests for additional information directly to medical providers when processing authorization requests. Additionally, determination notification letters will be sent via fax immediately upon authorization. We believe this streamlined faxing process will improve efficiency and help you access the information you need to support our members more quickly and effectively. Once we go live with faxing UM letters for PIC HIV-SNP members, we will continue to mail UM determination letters for 90 days and after that, only notifications by fax will be sent to providers.
To facilitate this transition, the Provider Relations team has been reaching out to obtain and verify provider fax numbers. If you haven’t already submitted your updated fax information, you may do so by e-mailing your updates to [email protected].
Please submit your fax information now, even if you currently have few PIC HIV-SNP members. We are proactively building a comprehensive fax repository for all providers, members, and lines of business—including Medicaid, CHP, Medicare, MLTC, and others.