Common use of Utilization Management Program Clause in Contracts

Utilization Management Program. In rendering services to Beneficiaries of this Product, Physician will comply with Payor’s Utilization Management Program for this Product (“UM Program”) as set forth in the Policy and Procedure Manual. If, in the professional judgment of Physician, it is medically necessary, timely and appropriate to deliver health care services in a manner which differs from the UM Program, Physician will render health care services in a manner keeping with his/her best professional judgment irrespective of a Payor’s coverage decision.