Do plan health care providers receive financial incentives for my care? How are plan health care providers paid?
Health Maintenance Organization (HMO) plans review health care services to see if they are medically necessary. This process is called utilization review. Conducted by registered nurses and physicians at your HMO, reviews are based solely on the need for care and service. We do not compensate, reward or provide financial incentives to decision makers for denying coverage or services.
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