New Claims System Update

Provider Manual
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6 PROVIDER NETWORK INFORMATION

6.9 Incentives and Payment Arrangements

Financial arrangements concerning payment to providers for services to Medicare members are set forth in each provider’s agreement with IntegraNet. IntegraNet may also use financial incentives to reward providers for achieving certain quality indicator levels.

IntegraNet does not use or employ financial incentives that would directly or indirectly induce providers to limit or reduce medically necessary services furnished to individual enrollees. In cases where IntegraNet approves provider subcontracting arrangements, those subcontractors cannot employ any financial incentives inconsistent with this policy or with Medicare Advantage regulations.