Affirmative Statement about Incentives
Utilitization Management (UM) decision making is based on appropriateness of care and service and existence of coverage. Blue Cross of Idaho does not use incentives to encourage barriers to care and service. Blue Cross of Idaho does not compensate practitioners or individuals for denials, does not offer incentives to encourage denials, and does not encourage decisions that result in underutilization.
NCQA UM 4.F.1 | NCQA UM 4.F.2 | NCQA UM 4.F.3