Skip to main content

Affirmative Statement About Incentives

Provider news | Thursday, October 27, 2016

Attention all members, practitioners, providers and employees:

Santa Clara Family Health Plan affirms that:

  • Utilization Management (UM) decision-making is based only on appropriateness of care and services and existence of coverage.
  • The organization 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 underutilization.
  • Incentives, including compensation, for any person are not based on the quantity or type of denial decisions rendered.

For questions regarding this statement please call the Utilization Management Department at 1-408-874-1821.