EZ-NET Compatibility

NEMS Provider Portal is compatible with the following browsers: Google Chrome, Microsoft Edge, Firefox, and Safari

Utilization Management (UM) Affirmative Statement

Decision to approve or deny a service is based only on appropriateness of care, services, and existence of coverage. NEMS does not reward practitioners or other individuals for issuing denials of coverage or service care. Financial incentives for decision makers do not encourage decisions that result in underutilization. Members and providers may request a copy of the policies, procedures, and criteria used to make a determination for a specific procedure or condition by contacting NEMS UM at 1(415) 352-5186, option 1

UM Staff Availability

NEMS UM Staff is available to members and providers during regular business hours (Monday Through Friday, 8:00am - 5:30pm) to discuss UM issues, including denial decisions, request a copy of the policies, procedures and UM criteria, by calling 1(415) 352-5186,  option 1. TTY services 1(800) 735-2929 is available for the hearing impaired. NEMS provides language assistance for members whose primary language is not English. After normal business hours, UM staff can receive secure voicemail and fax. Our fax number is 1(415) 398-2895. Messages received are returned within one (1) business day. Our staff identifies by name, title and organization name when initiating or returning calls regarding UM issues.