Does Leon Medical Centers Health Plans provide incentives for Utilization Management decisions?
Leon Medical Centers Health Plans does not use incentives that encourage barriers to care and/or service, or that reward inappropriate restrictions of care. Rather, Leon Medical Centers Health Plans encourages appropriate utilization while discouraging any under-utilization. Leon Medical Centers Health Plans affirms that utilization management decision-making is based only on appropriateness of care and services and existance of coverage. Leon Medical Centers Health Plans does not reward practitioners or other individuals conducting utilization reviews for issuing denials of coverae of service or care. No incentives are offered to encourage decisions that might result in under-utilization.
