Medical management by physicians and nurse care coordinators is provided by the Funds’ Medical Manager. They coordinate resources to meet individual beneficiary health needs. Treatment alternatives are discussed with the physician, the beneficiary and the family. Nurse case managers assess the needs of the beneficiary and coordinate the plan of services agreed to by the physician, beneficiary and the family. For medical management programs, contact the Funds’ Medical Manager at 1-800-292-2288.
Pre-certification of medical services for the Funds is provided by the Funds’ Medical Manager. A physician or a licensed facility rendering the service or the beneficiary may contact the Funds’ Medical Manager to obtain pre-certification by letter, telephone or fax at:
UMWA Health and Retirement Funds
PO BOX 292167
Nashville, TN 37229
You should pre-certify Inpatient hospital stays, skilled nursing stays, rehabilitative therapy, mental health services, home health services, durable medical equipment, oxygen equipment and hearing aids.
If you are scheduling an elective surgery, the following should be pre-certified: organ transplants, intestinal or gastric bypass for obesity, cerebellar and dorsal stimulator implants, insertion of a prosthesis for cleft palate, plastic surgery including mammoplasty, and reduction mammoplasty.
For precertification of services, contact the Funds’ Medical Manager at 1-800-292-2288.