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Non-incentive programs

PerformCare does not provide incentives to employees who conduct utilization management activities for denying, limiting or discontinuing medically necessary services.

  • Utilization management (UM) decision-making is based only on appropriateness of care and service and existence of coverage
  • PerformCare does not specifically reward practitioners or other individuals for issuing denials of coverage or service care
  • Financial incentives for UM decision-makers do not encourage decisions that result in under-utilization