- 1. Utilization Management decision making is based only on appropriateness of care and service and existence of coverage.
- 2. The organization does not specifically reward practitioners or other individuals for issuing denials of coverage.
- 3. Financial incentives for Utilization Management decision makers do not encourage decisions that result in underutilization
Affirmative Statement About Incentives
Availability to criteria
A complete version of our proprietary evidence based clinical criteria is available for providers on the CarePortal at https://login.careportal.com If you are a provider and have not yet registered for the CarePortal, then please visit https://login.careportal.com to initiate registration. If you would like a copy of the criteria at no charge, please contact Care to Care at 1-888-216-7010.