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Affirmative Statement About Incentives

  • Utilization Management (UM) decision making is based only on appropriateness of care and service 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 under-utilization

Important Referral Information

  • Upon request, you may obtain a free copy of the actual benefit provision, guideline, protocol or other similar criteria on which an approval or denial decision was based by calling Arizona Priority Care at (480) 499-8750.
  • Additionally, any Provider may contact the Physician who reviewed any specific approved or denied referral determination directly by calling (480) 499-8720.
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