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GREATER COVINA MEDICAL GROUPMedical Administrators Arvind C. Lapsiwala, M.D.,
President & CEO
Meet Greater Covina Medical Group, an independent physician network of more than 300 primary care physicians and specialists with established practices conveniently located throughout the San Gabriel Valley. These well-respected, highly skilled doctors remain dedicated to helping and healing those who are ill, and maintaining the good health of the communities served. Closely affiliated with Citrus Valley Health Partners, Greater Covina Medical Group has implemented express referral programs in certain specialties for plan members to access care, without delay of prior authorization, thereby ensuring that the finest professional and cost-effective care is readily available.
Utilization Management Utilization Management decisions are made utilizing adopted nationally recognized criteria, along with other criteria developed by Greater Covina Medical Group. This information can be made available to you (the member) simply by contacting GCMG Utilization Management Department. Greater Covina Medical Group requires that all participating providers and staff who make utilization management decisions and those who supervise them sign a document affirming that a utilization management decision is based solely on the appropriateness of a given treatment and service, as well as the existence of coverage. The statements are kept on file at GCMG for patient review. GCMG does not specifically reward participating providers or other individuals conducting utilization management review for issuing denials of coverage. There are no financial incentives for utilization management decision makers that will encourage decisions that result in either the denial or modification of medically necessary covered services.
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