Individuals & Family Members

Medical necessity review criteria used by the Medical Management department of WellSpan Population Health Services are available by calling the Medical Management department, 717-851-6801 or 800-888-1929. The criteria will be sent to you by mail, fax or email. To file a complaint/grievance, please contact Customer Service at pophealthbenefits@wellspan.org or call us at the numbers above.

UM decision making is based only on appropriates of care and service, and existence of coverage. WPHS does not specifically reward practitioners or other individuals for issuing denials of coverage. No financial incentives exist for UM decision makers that encourage decisions that result in underutilization.