AFFIRMATIVE STATEMENT REGARDING UTILIZATION-RELATED INCENTIVES:

Utilization Management (UM) decision making is based solely on medical necessity, appropriateness of care and service, and existence of coverage, and that Crystal Coast Management Services Organization (CCMSO), on behalf of its contracted IPAs does not specifically compensate practitioners or individuals conducting utilization review for issuing denials, nor CCMSO offer incentives to encourage decisions that result in underutilization or denials.

Practitioners are ensured independence and impartiality in making referral decisions that will not influence the following: hiring, compensations, terminations, promotions, and/or any other similar matters.