Financial Incentives

Ongoing Mission to Improve Access to Quality Care

In compliance with the National Committee for Quality Assurance (NCQA) standards, INTotal Health distributes this Affirmative Statement regarding Utilization Management (UM) decisions to all members, practitioners, providers, and employees annually. In doing so, we proudly affirm our mission of improving access to quality care for all our members. INTotal Health requires that employees who make UM decisions adhere to the following principles:
• INTotal Health’s Utilization Management decision-making is only based on appropriateness of care and service as well as existence of coverage.
• INTotal Health does not specifically reward practitioners or other individuals for issuing denials of coverage or care.
• Financial incentives for INTotal Health Utilization Management decision-makers do not encourage decisions that result in underutilization.