Health Plan Peer-to-Peer Review Resources
In accordance with Department of Healthcare and Family Services requirements, all Medicaid Managed Care Organizations must maintain a peer-to-peer (P2P) review process that enables treating physicians to discuss services subject to utilization management review with a clinical peer of the same or similar specialty.
Information about Illinois health plan peer review procedures may be found at the links below:
Aetna Better Health of Illinois
Blue Cross Community Health Plan
Blue Cross Blue Shield of Illinois | Medicaid (find P2P information under “Utilization Management”)
Humana
Humana Dual Fully Integrated (HMO-D-SNP) in Illinois | Provider Documents and Resources (find P2P information in the provider manual)
Meridian and YouthCare
Molina Healthcare