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Utilization Management Incentives Policy



The following is the policy of SelectHealth on financial incentives related to utilization and utilization management-related decisions:
  1. UM decision-making by SelectHealth employees is to be based on the appropriateness of care and service and the existence of coverage.
  2. SelectHealth does not specifically reward providers or other individuals who conduct UM for issuing denials of coverage or service care either in particular cases or generally.
SelectHealth does not provide financial incentives for UM personnel that encourage decisions that result in under-utilization of services otherwise needed by members.

SelectHealth Medical Criteria Sets are available for providers to review upon request. To request information, providers should call 801-442-4305 or 800-442-4305.   UM staff are available to discuss UM issues from 8:00 am to 5:00 pm, Monday through Friday. Inbound communication via fax is available after normal business hours for UM issues at 801-442-0825.
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