Affirmative Statement About Incentives
BHPI adheres to the following principles related to the Utilization Management decision making:
- UM decision-making is based only on appropriateness of care and services and existence of coverage.
- BHPI does not reward practitioners or other individuals for issuing denials of coverage.
- There are no financial incentives for UM decision makers that would encourage decisions that result in underutilization. BHPI expressly prohibits such services.