As of April 1, 2006, HNE no longer requires prior approval for in-plan non-obstetrical elective inpatient admissions. Prior approval is still required for any procedure that requires pre-certification for clinical criteria (examples include but are not limited to bariatric surgery, human organ transplant and bone marrow transplant, and Rhinoplasty).  Inpatient admissions are still subject to utilization management (UM) review.   HNE's utilization management program is designed to provide access to the care our members need by assuring appropriate use of health care services. Through this program, we review certain claims and medical records to determine if services are covered benefits and are medically necessary and appropriate. Our medical director oversees the UM process and supervises all activities.