Affirmative

Affirmation Statement
 Utilization Management (UM) decision making is based only on appropriateness
of care, service and existence of coverage.
 Physicians Health Network does not specifically reward practitioners or
other individuals for issuing denials of coverage or service care.
 Physicians Health Network does not offer financial incentives to UM
decision makers that encourage decisions that result in underutilization.
 Our practitioners are ensured independence and impartiality in making referral
decisions that will not influence: influence hiring, compensation or financial gain,
termination, promotion any other similar matters.