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Safeguard in Utilization


Past Issues



Logo of ProMedica Health System; www.promedica.org

 Fall 2006

Safeguard in Utilization

Photo of doctorsParamount’s utilization management decisions are based only on appropriateness of care and service. Utilization management staff and associate medical/clinical directors are not financially or otherwise paid to encourage underutilization and/or denials of services.

In fact, Paramount monitors and analyzes monthly reports for patterns of underutilization and takes action to address any identified problems. In addition, nursing staff cannot deny services — denials can be made only by board certified, locally participating physicians.