How to Access Utilization Management

If you need to reach Utilization Management (UM), staff may be contacted Monday through Friday, from 8:00 a.m. to 5:00 p.m., by calling 630-859-6925 or 800-806-0051. Calls before and after these hours are taken by a voice mail system and will be returned within one business day.

Dreyer Medical Clinic offers access to TDD/TYY services to deaf, hard of hearing or speech impaired members at no cost to the member.  Members may contact UM by dialing Illinois Relay (7-1-1) or TTY users may call 800-526-0844, Voice users may call 800-526-0857; Spanish speaking TTY users may call 800-501-0864; Telebraille users may call 877-526-6670.

Dreyer Medical Clinic offers language assistance in the requested language (through bilingual staff or interpreters) for members to discuss UM issues during regular business hours at no cost to the member

Utilization Management Affirmation Statement

UM decisions are based on medical necessity, which includes appropriateness of care and services, and the existence of available benefits. As an organization, Dreyer does not specifically reward practitioners, health plan staff, or other individuals for issuing denials of coverage, care or services, and no incentive programs are utilized to encourage decisions that result in under-utilization. Dreyer also affirms that there is no conflict of interest between the medical group’s independent practice association and its’ UM decisions-makers.

Referral Information

If you are an HMO Illinois/Blue Advantage or Humana HMO/Humana Medicare patient and you have been referred out of Dreyer Medical Clinic for services, please wait to make your appointment until after you have received your written referral. It is your responsibility to bring your referral with you to your appointment.

Case Management

Case Management is a service that is available to Dreyer Medical Clinic HMO members (HMO of Illinois, Blue Advantage, Humana Commercial, and Humana Medicare.) Case Management is the coordination of services for members with multiple or complex medical conditions. Through the case management process, these members are helped to access care and services. The goal is to help members regain optimal health or improved functional capacity. If you feel that you may benefit from Case Management, please call the Utilization Management Department at 630-859-6925 and choose option 3 to speak with a Case Manager.